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Updated: Oct 14, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

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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Left ventricular epicardial pacing achieved hyper-responsiveness in young children with dilated cardiomyopathy with

Sijuan Sun1, Xiaofeng Guo2, Yiwei Chen1

  • 1Department of Cardiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.

ESC Heart Failure
|November 3, 2021
PubMed

Insights

Left ventricular epicardial pacing effectively treats heart failure in young children with dilated cardiomyopathy and left bundle branch block. This intervention significantly improves cardiac function and reduces heart size in this vulnerable population.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • Heart failure (HF) management in young children presents unique challenges.
  • Dilated cardiomyopathy with left bundle branch block (LBBB) in pediatric patients often leads to severe cardiac dysfunction.
  • Current treatment options for refractory HF in this population are limited.

Purpose of the Study:

  • To evaluate the efficacy of left univentricular epicardial pacing in children with dilated cardiomyopathy and LBBB.
  • To assess the impact of epicardial pacing on cardiac dimensions and function.

Main Methods:

  • A cohort of five pediatric patients with dilated cardiomyopathy and LBBB underwent left univentricular epicardial pacing implantation via minithoracotomy.
  • Patients presented with refractory HF, cardiac dilatation, and impaired left ventricular ejection fraction (33.48 ± 5.84%).
  • Electrical and mechanical dyssynchrony were confirmed by QRS duration >140 ms and prolonged septal-to-left posterior wall motion delay.

Main Results:

  • Successful implantation of left ventricular epicardial pacing was achieved in all five children.
  • Following pacing, significant improvement in left ventricular dimensions (55.62 ± 3.46 to 38.94 ± 3.69 mm) was observed.
  • Left ventricular ejection fraction improved from 33.48 ± 5.84% to 60.18 ± 8.78% during a mean follow-up of 10.8 months.

Conclusions:

  • Left ventricular epicardial pacing is a highly effective treatment for pediatric heart failure secondary to LBBB, even in low-body-weight children.
  • The procedure led to significant cardiac reverse remodeling and functional improvement.
  • Epicardial pacing offers a promising therapeutic strategy for young children with refractory heart failure and LBBB.
Abstract

Keywords:
CardiomyopathyChildrenHeart failureLeft bundle branch blockLeft univentricular pacing

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