Validation of an animal model of right ventricular dysfunction and right bundle branch block to create close physiology to postoperative tetralogy of Fallot.
BACKGROUND
In the past 5 years a few number of studies and case reports have come out focusing on biventricular (BiV) stimulation for treatment of congenital heart disease related ventricular dysfunction. The few available studies include a diverse group of pathophysiological entities ranging from a previously repaired tetralogy of Fallot (TOF) to a functional single ventricle anatomy. Patient's status is too heterogeneous to build important prospective study. To well understand the implication of prolonged electromechanical dyssynchrony we performed a chronic animal model that mimics essential parameters of postoperative TOF.


METHODS
Significant pulmonary regurgitation, mild stenosis, as well as right ventricular outflow tract (RVOT) scars were induced in 15 piglets to mimic repaired TOF. 4 months after hemodynamics and dyssynchrony parameters were compared with a control group and with a population of symptomatic adult with repaired TOF.


RESULTS
Comparing the animal model with the animal control group on echocardiography, RV dilatation, RV and LV dysfunction, broad QRS complex and dyssynchrony were observed on the animal model piglets. Moreover, epicardial electrical mapping showed activation consistent with a right bundle branch block. The animal models displayed the same pathophysiological parameters as the post TOF repair patients in terms of QRS duration, pulmonary regurgitation biventricular dysfunction and dyssynchrony.


CONCLUSIONS
This chronic swine model mimics electromechanical ventricular activation delay, RV and LV dysfunction, as in adult population of repair TOF. It does appear to be a very useful and interesting model to study the implication of dyssynchrony and the interest of resynchronization therapy in TOF failing ventricle.
Thambo
Jean-Benoit
JB
University Hospital of Bordeaux, 33000 Bordeaux, France. jean-benoit.thambo@chu-bordeaux.fr
Roubertie
Francois
F
De Guillebon
Maxime
M
Labrousse
Louis
L
Iriart
Xavier
X
Ntsinjana
Hopewell
H
Lafitte
Stephane
S
Ploux
Sylvain
S
Haissaguerre
Michel
M
Roques
Xavier
X
Dos Santos
Pierre
P
Bordachar
Pierre
P
D000328:Adult; D000818:Animals; D002037:Bundle-Branch Block / Q000000981:diagnostic imaging; D004195:Disease Models, Animal; D006801:Humans; D011446:Prospective Studies; D013552:Swine; D013771:Tetralogy of Fallot / Q000601:surgery; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging