Systolic left ventricular apical bulging after biventricular pacing mimicking takotsubo cardiomyopathy.
Resolution of the issue of nonresponsiveness to cardiac resynchronization therapy (CRT) remains crucial to the successful treatment of conduction disturbances in heart failure. In this study, a patient with refractory heart failure including left bundle branch block was treated via surgical CRT. The epicardial left ventricular (LV) lead, implanted using thoracoscopic guidance, was unexpectedly located on the apical side. Echocardiographic findings of the LV motion mimicked takotsubo cardiomyopathy. The LV lead was successfully re-implanted along a lateral branch of the cardiac vein using an endovascular approach, resulting in restored contractility and reversal of the LV remodeling.
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Takayuki
T
Nagai
Department of Cardiology, Ehime Prefectural Central Hospital, 83 Kasuga-cho, Matsuyama, Ehime, 790-0024, Japan. c-hokayama@eph.pref.ehime.jp.
Hideki
H
Okayama
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Katsuji
K
Inoue
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Kazuhisa
K
Nishimura
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Chiharuko
C
Iio
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Kaori
K
Fujimoto
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Tamami
T
Kohno
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Akira
A
Fujii
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Teruyoshi
T
Uetani
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Jun
J
Suzuki
Ohtsuka Cardiovascular Clinic, Matsuyama, Ehime, Japan.
Tomoaki
T
Ohtsuka
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Jitsuo
J
Higaki
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Akiyoshi
A
Ogimoto
Cardiac resynchronization therapy; Non-responder; Speckle tracking echocardiography; Takotsubo cardiomyopathy