Successful cardiac resynchronization therapy in a 9-year-old boy with dilated cardiomyopathy.
Despite increasing clinical impact of cardiac resynchronization therapy (CRT) with av-synchronous biventricular pacing in adults with dilated cardiomyopathy (DCMP), an ejection fraction (EF) of less than 35% and left bundle branch block (LBBB), there is still only little experience in children. We report on a 9-year-old boy with histologically proven DCMP and LBBB who had fulfilled the criteria for heart transplantation (HTX) after cardiac decompensation including catecholamine therapy. A transvenous CRT pacing system was implanted without technical difficulties. The healing process was uneventful. With optimized AV-interval invasive evaluation during implantation indicated a 16% pulse pressure increase and a 63% augmentation of LV dp/dt by pacing the LV 20 ms prior to the RV. Tissue Doppler imaging demonstrated complete LV resynchronization. Physical capacity increased and HTX could be delayed.
Nürnberg
J-H
JH
Abteilung für Angeborene Herzfehler/Kinderkardiologie, Klinikum Links der Weser, Senator-Weissling-Str. 1, 28277 Bremen, Germany. jan-hendrik.nuernberg@klinikum-bremen-ldw.de
Butter
C
C
Abdul-Khaliq
H
H
Schlegl
M
M
Lange
P E
PE
D002037:Bundle-Branch Block / Q000628:therapy*; D006328:Cardiac Catheterization; D002303:Cardiac Output, Low / Q000628:therapy*; D002311:Cardiomyopathy, Dilated / Q000628:therapy*; D002648:Child; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005240:Feasibility Studies; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000628:therapy*; D008297:Male; D010138:Pacemaker, Artificial; D016896:Treatment Outcome