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Updated: Jan 18, 2026

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 to Aid Ventricular Assist Device Explantation in Infants with Cardiomyopathy and

Anila A Chaudhary1, Chandra Srinivasan2, Katsuhide Maeda3

  • 1Division of Cardiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA. Chaudharaa@chop.edu.

Pediatric Cardiology
|September 11, 2025
PubMed

Insights

Two infants with heart failure and left bundle branch block (LBBB) improved with a ventricular assist device (LVAD). Cardiac resynchronization therapy (CRT) enabled successful LVAD removal, highlighting CRT

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • Infants with severe left ventricular (LV) dysfunction and left bundle branch block (LBBB) present complex clinical challenges.
  • Left ventricular assist devices (LVADs) offer mechanical support but may not fully resolve dyssynchrony caused by LBBB.

Purpose of the Study:

  • To evaluate the role of cardiac resynchronization therapy (CRT) in facilitating LVAD explantation in infants with LBBB.
  • To explore CRT as a strategy for managing persistent ventricular dyssynchrony post-LVAD support.

Main Methods:

  • Case report of two previously healthy infants with dilated cardiomyopathy and LBBB.
  • Initial management with Berlin Heart EXCOR LVAD and serial echocardiograms.
  • LVAD turn-down trials to assess native LV function and dyssynchrony.
  • Successful LVAD explantation with simultaneous epicardial lead placement for biventricular CRT.

Main Results:

  • Both infants demonstrated improved LV function during LVAD support but persistent septal dyskinesis due to LBBB.
  • Successful LVAD explantation was achieved in both patients after CRT implantation.
  • Post-explantation follow-up indicated sustained benefit from CRT in managing dyssynchrony.

Conclusions:

  • Cardiac resynchronization therapy (CRT) can be a viable strategy to aid in the successful explantation of ventricular assist devices in select pediatric patients with LBBB and echocardiographic evidence of dyssynchrony.
  • This approach may improve long-term outcomes by addressing the underlying electrical dyssynchrony that impedes native cardiac recovery after mechanical support.

Keywords:
Cardiac resynchronization therapyExplantationHeart failureLeft bundle branch blockPediatricVentricular assist deviceVentricular recovery

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