title: Cardiac resynchronization therapy in patients with challenging anatomy due to venous anomalies or adult congenital heart disease.
abstract: BACKGROUND
  Cardiac resynchronization therapy (CRT) has proven salutary effects in patients with congestive heart failure, systolic dysfunction, and electromechanical dyssynchrony in the setting of ischemic, nonischemic, and congenital cardiomyopathy. While CRT device implants have become routine in the adult ischemic or nonischemic cardiomyopathy populations, patients with congenital heart disease offer special challenges due to unusual anatomic variations.
  
  
  METHODS
  A comprehensive assessment of anatomic abnormalities is essential prior to implant. In addition, implant techniques and equipment must be tailored to the expected anatomy. A flexible approach is necessary-implant may require equipment and techniques adapted from vascular intervention.
  
  
  CONCLUSIONS
  This article describes our approach to CRT implant in patients with congenital heart disease, and is illustrated by reports of several cases.
authors.affiliation: Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin.
authors.forename: Imran
authors.initials: I
authors.lastname: Niazi
authors.forename: Anwer
authors.initials: A
authors.lastname: Dhala
authors.forename: Indrajit
authors.initials: I
authors.lastname: Choudhuri
authors.forename: Jasbir
authors.initials: J
authors.lastname: Sra
authors.forename: Masood
authors.initials: M
authors.lastname: Akhtar
authors.forename: Abdul Jamil
authors.initials: AJ
authors.lastname: Tajik
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000628:therapy*; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D003330:Coronary Vessel Anomalies / Q000150:complications*; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006333:Heart Failure / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: adult congenital heart disease; cardiac resynchronization therapy; heart failure; implant techniques; implantable defibrillator; pacemaker