title: Upgrade from ICD to CRT-D: clinical and haemodynamic impact of biventricular pacing in a patient with acquired long QT syndrome.
abstract: Long QT syndrome (LQTS) is characterised by both the depolarisation and repolarisation disorder of cardiac muscle cells. Cardiac resynchronising therapy (CRT) is an important treatment option for patients with chronic heart failure (CHF) when echocardiographic and electrocardiographic criteria are met. Although CRT was introduced in clinical practice 10 years ago, doubts related to application of this treatment method persist because of its potential proarrhythmogenic effect. This is a case describing a 66-year-old Caucasian female with LQTS coexisting with a left bundle branch branch block (LBBB) and an implantable single-cavity cardioverter-defibrillator (ICD VR), who had repeated appropriate high-energy treatments. The upgrade to resynchronisation therapy defibrillator (CRT-D) significantly reduced frequency of ventricular tachycardia and the need for electrical therapies. The normalisation of the left ventricle size, as seen on echo examination, and the improvement of heart failure symptoms were also observed.
authors.affiliation: 2 Department of Cardiology in Zabrze, Medical University of Silesia in Katowice, Sklodowskiej-Curie 10 Street, 41-800 Zabrze, Poland.
authors.forename: Damian
authors.initials: D
authors.lastname: Kawecki
authors.affiliation: 2 Department of Cardiology in Zabrze, Medical University of Silesia in Katowice, Sklodowskiej-Curie 10 Street, 41-800 Zabrze, Poland, Tel: +48 32 271 10 10;
authors.forename: Janusz
authors.initials: J
authors.lastname: Dola
authors.affiliation: 2 Department of Cardiology in Zabrze, Medical University of Silesia in Katowice, Sklodowskiej-Curie 10 Street, 41-800 Zabrze, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Jacheć
authors.affiliation: 2 Department of Cardiology in Zabrze, Medical University of Silesia in Katowice, Sklodowskiej-Curie 10 Street, 41-800 Zabrze, Poland.
authors.forename: Celina
authors.initials: C
authors.lastname: Wojciechowska
authors.affiliation: Faculty of Medicine, Medical University of Silesia in Katowice, 18 Medyków Street, 40-752 Katowice, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Morawski
authors.affiliation: 2 Department of Cardiology in Zabrze, Medical University of Silesia in Katowice, Sklodowskiej- Curie 10 Street, 41-800 Zabrze, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Tomasik
authors.affiliation: 2 Department of Cardiology in Zabrze, Medical University of Silesia in Katowice, Sklodowskiej-Curie 10 Street, 41-800 Zabrze, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Nowalany-Kozielska
keywords: Torsade de Pointes (TdP); cardiac resynchronising therapy (CRT); heart failure (HF); implantable cardioverter-defibrillator (ICD); long QT syndrome (LQTS); polymorphic ventricular tachycardia; resynchronisation therapy defibrillator (CRT-D)