This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Janousek, J. Articles by Hucín, B. Search for Related Content PubMed PubMed Citation Articles by Janousek, J. Articles by Hucín, B.

EXPRESS PUBLICATION

Cardiac resynchronization therapy: A novel adjunct to the treatment and prevention of systemic right ventricular failure

Jan Janouek, MD^*,*, Viktor Tomek, MD^*, Václav Chaloupeck, MD, PhD^*, Oleg Reich, MD, PhD^*, Roman A. Gebauer, MD^*, Josef Kautzner, MD, PhD and Bohumil Huín, MD, PhD^*

^* Kardiocentrum, University Hospital Motol
Institute for Clinical and Experimental Medicine, Prague, Czech Republic

Manuscript received July 6, 2004; accepted August 17, 2004.

^* Reprint requests and correspondence: Dr. Jan Janouek, Kardiocentrum, University Hospital Motol, V úvalu 84, 150 06 Prague, Czech Republic (Email: jan.janousek{at}lfmotol.cuni.cz).

OBJECTIVES: This study aimed to evaluate the technical feasibility and hemodynamic benefit of cardiac resynchronization therapy (CRT) in patients with systemic right ventricle (RV).

BACKGROUND: Patients with a systemic RV are at high risk of developing heart failure. Cardiac resynchronization therapy may improve RV function in those with electromechanical dyssynchrony.

METHODS: Eight patients (age 6.9 to 29.2 years) with a systemic RV and right bundle-branch block (n = 2) or pacing from the left ventricle (LV) (n = 6) with a QRS intervalof 161 ± 21 ms underwent CRT (associated with cardiac surgery aimed at decrease in tricuspid regurgitation in 3 of 8 patients) and were followed-up for a median of 17.4 months.

RESULTS: Change from baseline rhythm to CRT was accompanied by a decrease in QRS interval (–28.0%, p = 0.002) and interventricular mechanical delay (–16.7%, p = 0.047) and immediate improvement in the RV filling time (+10.9%, p = 0.002), Tei index (–7.7%, p = 0.008), estimated RV maximum +dP/dt(+45.9%, p = 0.007), aortic velocity-time integral (+7.0%, p = 0.028), and RV ejection fraction by radionuclide ventriculography (+9.6%, p = 0.04). The RV fractional area of change increased from a median of 18.1% before resynchronization to 29.5% at last follow-up (p = 0.008) without a significant change in the end-diastolic area (+4.0%, p = NS).

CONCLUSIONS: The CRT yielded improvement in systemic RV function in patients with spontaneous or LV pacing-induced electromechanical dyssynchrony and seems to be a promising adjunct to the treatment and prevention of systemic RV failure.

Abbreviations and Acronyms   AV = atrioventricular   CRT = cardiac resynchronization therapy   RV = right ventricle/ventricular   LV = left ventricle/ventricular

This article has been cited by other articles:

				J Janousek, R A Gebauer, H Abdul-Khaliq, M Turner, L Kornyei, O Grollmuss, E Rosenthal, E Villain, A Fruh, T Paul, et al. Cardiac resynchronisation therapy in paediatric and congenital heart disease: differential effects in various anatomical and functional substrates Heart, July 15, 2009; 95(14): 1165 - 1171. [Abstract] [Full Text] [PDF]

				M. K. Friedberg and L. Mertens Tissue velocities, strain, and strain rate for echocardiographic assessment of ventricular function in congenital heart disease Eur J Echocardiogr, July 1, 2009; 10(5): 585 - 593. [Abstract] [Full Text] [PDF]

				P. A. Zartner, W. Wiebe, M. Volkmer, D. Thomas, and M. Schneider Transvenous cardiac resynchronization therapy in complex congenital heart diseases: dextrocardia with transposition of the great arteries after Mustard operation Europace, April 1, 2009; 11(4): 530 - 532. [Abstract] [Full Text] [PDF]

				G. Jauvert, J. Rousseau-Paziaud, E. Villain, L. Iserin, F. Hidden-Lucet, M. Ladouceur, and D. Sidi Effects of cardiac resynchronization therapy on echocardiographic indices, functional capacity, and clinical outcomes of patients with a systemic right ventricle Europace, February 1, 2009; 11(2): 184 - 190. [Abstract] [Full Text] [PDF]

				J. E. Deanfield, R. Yates, F. J. Meijboom, and B. J.M. Mulder CHAPTER 10 Congenital Heart Disease in Children and Adults ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF]

				C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease) Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., December 2, 2008; 52(23): e143 - e263. [Full Text] [PDF]

				C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, December 2, 2008; 118(23): e714 - e833. [Full Text] [PDF]

				T. Urashima, M. Zhao, R. Wagner, G. Fajardo, S. Farahani, T. Quertermous, and D. Bernstein Molecular and physiological characterization of RV remodeling in a murine model of pulmonary stenosis Am J Physiol Heart Circ Physiol, September 1, 2008; 295(3): H1351 - H1368. [Abstract] [Full Text] [PDF]

				I. Garcia-Bolao, B. Lopez, A. Macias, J. J. Gavira, P. Azcarate, and J. Diez Impact of collagen type I turnover on the long-term response to cardiac resynchronization therapy Eur. Heart J., April 1, 2008; 29(7): 898 - 906. [Abstract] [Full Text] [PDF]

				A. Vitarelli, P. Franciosa, and S. Rosanio Tissue Doppler Imaging in the assessment of selection and response from cardiac resynchronization therapy Eur J Echocardiogr, October 1, 2007; 8(5): 309 - 316. [Abstract] [Full Text] [PDF]

				Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association Europace, October 1, 2007; 9(10): 959 - 998. [Full Text] [PDF]

				Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association Eur. Heart J., September 2, 2007; 28(18): 2256 - 2295. [Full Text] [PDF]

				V. Bautista-Hernandez, G. R. Marx, K. Gauvreau, J. E. Mayer Jr, F. Cecchin, and P. J. del Nido Determinants of Left Ventricular Dysfunction After Anatomic Repair of Congenitally Corrected Transposition of the Great Arteries Ann. Thorac. Surg., December 1, 2006; 82(6): 2059 - 2066. [Abstract] [Full Text] [PDF]

				T. A. Quinn, G. Berberian, S. E. Cabreriza, L. J. Maskin, A. D. Weinberg, J. W. Holmes, and H. M. Spotnitz Effects of sequential biventricular pacing during acute right ventricular pressure overload Am J Physiol Heart Circ Physiol, November 1, 2006; 291(5): H2380 - H2387. [Abstract] [Full Text] [PDF]

				G.-P. Diller, D. Okonko, A. Uebing, S. Y. Ho, and M. A. Gatzoulis Cardiac resynchronization therapy for adult congenital heart disease patients with a systemic right ventricle: analysis of feasibility and review of early experience. Europace, April 1, 2006; 8(4): 267 - 272. [Abstract] [Full Text] [PDF]

				A. M. Dubin, J. Janousek, E. Rhee, M. J. Strieper, F. Cecchin, I. H. Law, K. M. Shannon, J. Temple, E. Rosenthal, F. J. Zimmerman, et al. Resynchronization Therapy in Pediatric and Congenital Heart Disease Patients: An International MultiCenter Study J. Am. Coll. Cardiol., December 20, 2005; 46(12): 2277 - 2283. [Abstract] [Full Text] [PDF]

				P. Ammann, C. Sticherling, D. Kalusche, J. Eckstein, A. Bernheim, B. Schaer, and S. Osswald An Electrocardiogram-Based Algorithm To Detect Loss of Left Ventricular Capture during Cardiac Resynchronization Therapy Ann Intern Med, June 21, 2005; 142(12_Part_1): 968 - 973. [Abstract] [Full Text] [PDF]

				T. P. Graham Jr The Year in Congenital Heart Disease J. Am. Coll. Cardiol., June 7, 2005; 45(11): 1887 - 1899. [Full Text] [PDF]