Pulmonary Right Ventricular Resynchronization in Congenital Heart Disease Acute Improvement in Right Ventricular Mechanics and Contraction Efficiency

Jan Janousek*, Jan Kovanda, Miroslav Lozek, Viktor Tomek, Pavel Vojtovic, Roman Gebauer, Peter Kubus, Miroslav Krejcir, Joost Lumens, Tammo Delhaas, Frits Prinzen

*Corresponding author for this work

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Abstract

Background-Electromechanical discoordination may contribute to long-term pulmonary right ventricular (RV) dysfunction in patients after surgery for congenital heart disease. We sought to evaluate changes in RV function after temporary RV cardiac resynchronization therapy.

Methods and Results-Twenty-five patients aged median 12.0 years after repair of tetralogy of Fallot and similar lesions were studied echocardiographically (n=23) and by cardiac catheterization (n=5) after primary repair (n=4) or after surgical RV revalvulation for significant pulmonary regurgitation (n=21). Temporary RV cardiac resynchronization therapy was applied in the presence of complete right bundle branch block by atrial-synchronized RV free wall pacing in complete fusion with spontaneous ventricular depolarization using temporary electrodes. The q-RV interval at the RV free wall pacing site (mean 77.2% of baseline QRS duration) confirmed pacing from a late activated RV area. RV cardiac resynchronization therapy carried significant decrease in QRS duration (P

Conclusions-In patients with congenital heart disease and right bundle branch block, RV cardiac resynchronization therapy carried multiple positive effects on RV mechanics, synchrony, and contraction efficiency.

Original languageEnglish
Article number006424
Number of pages10
JournalCirculation-Cardiovascular Imaging
Volume10
Issue number9
DOIs
Publication statusPublished - Sep 2017

Keywords

  • cardiac resynchronization therapy
  • echocardiography
  • heart defects, congenital
  • pediatrics
  • right ventricle
  • tetralogy of Fallot
  • FAILING RIGHT VENTRICLE
  • BUNDLE-BRANCH BLOCK
  • VALVE-REPLACEMENT
  • CARDIAC-RESYNCHRONIZATION
  • FALLOT REPAIR
  • TETRALOGY
  • THERAPY
  • ADULTS
  • DYSSYNCHRONY
  • CHILDREN

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