Electrical resynchronization: a novel therapy for the failing right ventricle.
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.


RESULTS
We studied 7 patients with RV dysfunction and RBBB, using a predefined pacing protocol. QRS duration, cardiac index (CI), and RV dP/dt were measured in 4 different pacing states. Atrioventricular pacing improved CI and RV dP/dtmax and decreased QRS duration as compared with atrial pacing or sinus rhythm.


CONCLUSIONS
Atrioventricular pacing in patients with RBBB and RV dysfunction augments RV and systemic performance. RV resynchronization is a promising novel therapy for patients with RV failure.
Dubin
Anne M
AM
Department of Pediatrics, Stanford University, 750 Welch Rd, Suite #305, Stanford, Calif 94304, USA. amdubin@leland.stanford.edu
Feinstein
Jeffrey A
JA
Reddy
V Mohan
VM
Hanley
Frank L
FL
Van Hare
George F
GF
Rosenthal
David N
DN
D000293:Adolescent; D000328:Adult; D002037:Bundle-Branch Block / Q000209:etiology / Q000628:therapy; D002304:Cardiac Pacing, Artificial; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D017725:Ventricular Pressure