Bifocal right ventricular resynchronization for the failing right ventricle.
The present case illustrates 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 (LV) pump function, even in cases with various degrees of atrioventricular block. The acute response to different pacing configurations was analyzed in terms of dP/dt variations. Bifocal RV pacing (His bundle plus RV outflow tract pacing) achieved the best acute results and was chosen for permanent pacing. This pacing configuration was associated to clinical and echocardiographic improvement.
Berruezo
Antonio
A
Thorax Institute-Hospital Clinic, University of Barcelona, Cardiology Department, Barcelona, Catalonia, Spain. berruezo@clinic.ub.es
De Potter
Tom
T
Sitges
Marta
M
Mansour
Fadi
F
Mont
Lluis
L
Brugada
Josep
J
D054537:Atrioventricular Block / Q000628:therapy; D002036:Bundle of His / Q000503:physiopathology; D002037:Bundle-Branch Block / Q000628:therapy; D058406:Cardiac Resynchronization Therapy; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology