title: Validation of an animal model of right ventricular dysfunction and right bundle branch block to create close physiology to postoperative tetralogy of Fallot.
abstract: 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.
authors.affiliation: University Hospital of Bordeaux, 33000 Bordeaux, France. jean-benoit.thambo@chu-bordeaux.fr
authors.forename: Jean-Benoit
authors.initials: JB
authors.lastname: Thambo
authors.forename: Francois
authors.initials: F
authors.lastname: Roubertie
authors.forename: Maxime
authors.initials: M
authors.lastname: De Guillebon
authors.forename: Louis
authors.initials: L
authors.lastname: Labrousse
authors.forename: Xavier
authors.initials: X
authors.lastname: Iriart
authors.forename: Hopewell
authors.initials: H
authors.lastname: Ntsinjana
authors.forename: Stephane
authors.initials: S
authors.lastname: Lafitte
authors.forename: Sylvain
authors.initials: S
authors.lastname: Ploux
authors.forename: Michel
authors.initials: M
authors.lastname: Haissaguerre
authors.forename: Xavier
authors.initials: X
authors.lastname: Roques
authors.forename: Pierre
authors.initials: P
authors.lastname: Dos Santos
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
mesh_terms: 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