Electrical Resynchronization: A Novel Therapy for the Failing Right Ventricle

  title={Electrical Resynchronization: A Novel Therapy for the Failing Right Ventricle},
  author={Anne M. Dubin and Jeffrey A. Feinstein and Vadiyala Mohan Reddy and Frank Louis Hanley and George F. Van Hare and David N. Rosenthal},
  journal={Circulation: Journal of the American Heart Association},
Background—Many patients with congenital heart disease develop right ventricular (RV) failure due to anatomy and prior therapy. RV problems may include right bundle-branch block (RBBB), volume loading, and chamber enlargement. Because the failing RV may have regional dyskinesis, we hypothesized that resynchronization therapy might augment its performance. Methods and Results—We studied 7 patients with RV dysfunction and RBBB, using a predefined pacing protocol. QRS duration, cardiac index (CI… 

Pulmonary Right Ventricular Resynchronization in Congenital Heart Disease: Acute Improvement in Right Ventricular Mechanics and Contraction Efficiency

In patients with congenital heart disease and right bundle branch block, RV cardiac resynchronization therapy carried multiple positive effects on RV mechanics, synchrony, and contraction efficiency.

Bifocal Right Ventricular Resynchronization for the Failing Right Ventricle

It is shown that in patients with right ventricular (RV) failure and right bundle branch block it is possible to resynchronize the RV without further worsening RV or left ventricular pump function, even in cases with various degrees of atrioventricular block.

Cardiac Resynchronization Therapy: Retiming the Failing Right Ventricle

The case of an adult patient with transposition of the great arteries and previous Mustard's repair, who successfully underwent CRT using a hybrid transvenous/epicardial approach is reported, suggesting that CRT may offer a new therapeutic option for this patient population.

Electrical resychronization of failing right ventricle.

The authors concluded that patients with RV failure and electromechanical dyssynchrony could potentially be treated by electrical resynchronization.

Effects of cardiac resynchronization therapy on echocardiographic indices, functional capacity, and clinical outcomes of patients with a systemic right ventricle.

  • G. JauvertJuliette Rousseau-Paziaud D. Sidi
  • Medicine
    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
  • 2009
CRT was technically feasible and associated with improvements in cardiac mechanical function and clinical status in patients with TGA, failing systemic RV, and intraventricular dyssynchrony.

Cardiac Resynchronization Therapy for Pediatric Patients With Heart Failure and Congenital Heart Disease: A Reappraisal of Results

The effectiveness of CRT in the pediatric population is difficult to evaluate because of the complex anatomic substrates of congenital heart disease (CHD) and scar formation from multiple cardiac surgeries with a higher proportion of right bundle-branch block (RBBB) and right ventricular (RV) failure than in the adult population.



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CRT with LV free wall stimulation produced significantly better LV systolic performance compared with anterior stimulation, and further studies are warranted to prove the clinical superiority of theLV free wall as a site for long-term CRT.

Cardiac resynchronization in chronic heart failure.

Effect of pacing chamber and atrioventricular delay on acute systolic function of paced patients with congestive heart failure. The Pacing Therapies for Congestive Heart Failure Study Group. The Guidant Congestive Heart Failure Research Group.

In this population of CHF patients with sufficiently wide surface QRS benefit from atrial-synchronous ventricular pacing, LV stimulation is required for maximum acute benefit, and the maximum benefit at any site occurs with a patient-specific AV delay.

Cardiac Resynchronization in Chronic Heart Failure

Cardiac resynchronization results in significant clinical improvement in patients who have moderate-to-severe heart failure and an intraventricular conduction delay.

Predictors of systolic augmentation from left ventricular preexcitation in patients with dilated cardiomyopathy and intraventricular conduction delay.

These results show that although mechanical dyssynchrony is a key predictor for pacing efficacy in DCM patients with conduction delay, combining information about QRS and basal dP/dt(max) provides an excellent tool to identify maximal responders.

Left Ventricular or Biventricular Pacing Improves Cardiac Function at Diminished Energy Cost in Patients With Dilated Cardiomyopathy and Left Bundle-Branch Block

Ventricular resynchronization by left ventricular or biventricular pacing/stimulation in DCM patients with left bundle-branch block acutely enhances systolic function while modestly lowering energy cost should prove valuable for treating DCM Patients with basal dyssynchrony.

A pilot experience with permanent biventricular pacing to treat advanced heart failure.

Biventricular pacing appears to improve the functional status of patients with dilated cardiomyopathy with advanced heart failure and appears to be attractive as an additive treatment, especially in class III patients.

Quantitation of the Global Right Ventricular Function in Children with Normal Heart and Congenital Heart Disease: A Right Ventricular Myocardial Performance Index

The Tei index is a feasible approach to use when assessing global RV function in children with congential heart disease and should be considered for use with regard to congenital heart disease.

Right ventricular diastolic function 15 to 35 years after repair of tetralogy of Fallot. Restrictive physiology predicts superior exercise performance.

Both restrictive and nonrestrictive groups had reduced exercise MVO2 compared with healthy age- and sex-matched control subjects, but those with restrictive physiology had significantly better maximum oxygen uptake than the nonRestrictive group (P < .001).