title: Cardiac resynchronization therapy as rescue therapy in end-stage heart failure: illustration by three-dimensional speckle tracking strain echocardiography.
abstract: We report the case of a 73-year-old man admitted for refractory heart failure following implantation of a dual-chamber pacemaker. Three-dimensional (3D) echocardiography with speckle tracking area strain identified severe left ventricular (LV) dysfunction and LV dyssynchrony following right ventricular pacing. As the patient's clinical condition rapidly worsened despite optimal medical treatment, a cardiac resynchronization therapy (CRT) pacemaker was successfully implanted as rescue therapy. Symptoms rapidly regressed and echocardiographic assessment following CRT demonstrated an immediate improvement in LV systolic function, confirmed at 9-month follow-up with evidence of reverse remodeling. New imaging technologies such as 3D echocardiography with speckle tracking area strain may help to identify and follow up patients who will benefit from CRT as rescue therapy.
authors.affiliation: Cardiology Department, Université Lille Nord de France/Groupement Hospitalier de l'Institut Catholique de Lille/Faculté Libre de Médecine, Université Catholique de Lille, Lille, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Guiot
authors.forename: Anne Laure
authors.initials: AL
authors.lastname: Castel
authors.forename: Yves
authors.initials: Y
authors.lastname: Guyomar
authors.forename: Estelle
authors.initials: E
authors.lastname: Cuvelier
authors.forename: François
authors.initials: F
authors.lastname: Delelis
authors.forename: Pierre
authors.initials: P
authors.lastname: Graux
authors.forename: Sylvestre
authors.initials: S
authors.lastname: Maréchaux
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D020257:Ventricular Remodeling / Q000502:physiology*