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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

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[Cardiac Resynchronization Therapy in the Treatment of Heart Failure in Children]

J Janouek1, I A Kovalev1, P Kubu1

  • 1Research Institute for Cardiology of the Research Centre of RAMS Siberian Branch, ul. Kievskaya 111a, 634012 Tomsk, Russia Childrens Heart Centre, University Hospital Motol, Prague, Czech Republic.

Kardiologiia
|March 16, 2017
PubMed

Insights

Cardiac resynchronization therapy (CRT) offers limited data for pediatric heart failure. Best outcomes are seen in children with complete atrioventricular block and dyssynchrony, while dilated cardiomyopathy predicts poor response.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Heart Failure Management

Context:

  • Cardiac resynchronization therapy (CRT) is established for adult heart failure.
  • Limited data and unclear indications exist for pediatric CRT application.
  • Pediatric heart failure presents unique anatomical and physiological challenges for CRT.

Purpose:

  • To review the pathophysiology of electromechanical dyssynchrony in pediatric heart failure.
  • To analyze clinical experience with CRT in children.
  • To suggest evidence-based indications for pediatric CRT.

Summary:

  • CRT is most effective in children with heart failure due to dyssynchrony from right ventricular pacing in complete atrioventricular block.
  • Dilated cardiomyopathy and advanced heart failure (NYHA class III-IV) predict poor CRT outcomes in pediatric patients.
  • Epicardial biventricular pacing is preferred for pediatric CRT due to anticipated long-term treatment duration and implantation challenges.

Impact:

  • Clarifies indications for CRT in pediatric heart failure.
  • Highlights challenges and preferred approaches for pediatric CRT device implantation.
  • Provides guidance for optimizing CRT outcomes in pediatric patients with specific heart conditions.

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