Cardiac resynchronization therapy: retiming the failing right ventricle.
Cardiac resynchronization therapy (CRT) improves symptoms, reduces hospitalization, and may decrease mortality in patients with moderate/severe heart failure and left bundle branch block. Whether CRT may have a role in the management of patients with adult congenital heart disease and a failing right (systemic) ventricle is unknown. We report 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. Exercise tolerance improved, right ventricular (systemic) ejection fraction improved, diuretic requirements reduced, and renal function improved. CRT may offer a new therapeutic option for this patient population.
Cowburn
Peter J
PJ
Department of Medicine, University of Toronto, Toronto, Canada.
Parker
John D
JD
Cameron
Douglas A
DA
Harris
Louise
L
D000328:Adult; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D013318:Stroke Volume / Q000502:physiology; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000503:physiopathology / Q000628:therapy*