Left ventricular pacing in the treatment of pediatric cardiac dysfunction caused by idiopathic complete left bundle
Xiaomei Li1,2, Jinghao Li1,2, Yongqiang Jin1
1Department of Pediatric Cardiology, Heart Center, the First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China.
Insights
Transthoracic epicardial dual-chamber pacemaker implantation effectively treats cardiac dysfunction in children with idiopathic complete left bundle branch block (CLBBB). This procedure restores normal cardiac function and synchrony, offering a viable treatment option.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
- Medical Device Technology
Background:
- Idiopathic complete left bundle branch block (CLBBB) can lead to significant cardiac dysfunction in children.
- Current treatment options for pediatric CLBBB-induced cardiac dysfunction are limited.
- Epicardial pacemaker implantation is a potential therapeutic strategy.
Purpose of the Study:
- To assess the feasibility and effectiveness of transthoracic epicardial dual-chamber pacemaker implantation.
- To evaluate the impact of this intervention on cardiac function and synchrony in pediatric patients with CLBBB.
- To determine the long-term outcomes of this treatment modality.
Main Methods:
- A cohort of nine children with cardiac dysfunction due to idiopathic CLBBB underwent transthoracic epicardial dual-chamber pacemaker implantation.
- Cardiac function was assessed using echocardiography.
- Intraventricular synchronization was evaluated with two-dimensional speckle tracking echocardiography (STE).
Main Results:
- All nine patients experienced normalization of cardiac function within one year post-implantation.
- Postoperative QRS duration significantly decreased compared to baseline.
- Preoperative cardiac dyssynchrony was completely corrected, with significant improvements in STE-derived synchronization parameters.
Conclusions:
- Transthoracic epicardial dual-chamber pacemaker implantation is a feasible and effective treatment for children with cardiac dysfunction caused by idiopathic CLBBB.
- The procedure leads to significant improvements in cardiac function and intraventricular synchrony.
- This approach offers a promising therapeutic option for this pediatric population.
Objective:
This study aimed to investigate the feasibility and effectiveness of transthoracic epicardial dual-chamber pacemaker implantation in the treatment of cardiac dysfunction caused by idiopathic complete left bundle branch block (CLBBB) in children.
Methods:
Nine children diagnosed with cardiac dysfunction due to idiopathic CLBBB were included in this study. All patients underwent transthoracic epicardial dual-chamber pacemaker implantation. Cardiac function was evaluated using echocardiography during the follow-up. Additionally, intraventricular synchronization parameters were assessed using two-dimensional speckle tracking echocardiography (STE).
Results:
Nine children (mean age, 3.0 ± 2.6 years) were included in this study. The median follow-up duration was 2 (interquartile range, 1-3) years. The cardiac function of all patients recovered to normal levels within 1 year postoperatively. The postoperative QRS duration on electrocardiography (142 ± 21 ms) was significantly shorter than that at baseline (106 ± 12 ms) (p < .05). Cardiac dyssynchrony in patients who manifested preoperatively achieved complete correction after pacemaker implantation. The comparison of preoperative and postoperative (last follow-up visit) synchronization parameters were as follows: longitudinal standard deviation of the time to peak strain, 99.0 ± 41.9 versus 36.8 ± 5.0 ms (p = .004); delay time of peak longitudinal strain, 252.2 ± 131.4 versus 35.0 ± 22.9 ms (p = .002); and longitudinal systolic dyssynchrony index, 2.8 ± 0.8% versus 1.0 ± 0.3% (p = .001), respectively.
Conclusion:
Transthoracic epicardial dual-chamber pacemaker implantation (with left atrial sensing and left ventricular single-site pacing) can be used for the treatment of cardiac dysfunction caused by idiopathic CLBBB in children.
More Related Videos
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
09:52Optocardiography and Electrophysiology Studies of Ex Vivo Langendorff-perfused Hearts
Published on: November 7, 2019
Related Concept Videos
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
01:29Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:25Dysrhythmias VI: Management of Dysrhythmias
01:19Conduction System of the Heart
The pacemaker cells are located in two primary nodes: the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node pacemaker cells can autonomously depolarize, triggering an action potential that leads to the...