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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

View larger version (26K): [in a new window]   Figure 1 Mid-term hemodynamic changes associated with cardiac resynchronization therapy (CRT). (A) Right ventricular maximum +dP/dt. Statistical significance by one-way repeated measures analysis of variance and paired t tests. (B) Right ventricular fractional area of change (RV FA). (C) Right ventricular end-diastolic area. (D) Grade of tricuspid valve regurgitation. Symbols indicate individual patients according to Table 1. BSA = body surface area; FUP = follow-up on CRT; implant. = implantation.

View larger version (106K): [in a new window]   Figure 2 Mixed lead system in a patient after the Senning procedure for transposition of great arteries (Patient #4) (Table 1). Two pre-existing unipolar ventricular leads (one is abandoned) are implanted transvenously at left ventricular mid-septum (LV). A bipolar epicardial lead is placed through the thoracotomy at the right ventricular free wall (RV) with good spatial separation of the RV and LV leads across the right ventricle. Presumed position of the tricuspid annulus is indicated. LAO = left anterior oblique projection; RA = right atrial lead; RAO = right anterior oblique projection.