Pulmonary Right Ventricular Resynchronization in Congenital Heart Disease Acute Improvement in Right Ventricular Mechanics and Contraction Efficiency
| Autor: | Jan Janoušek, Pavel Vojtovič, Jan Kovanda, Joost Lumens, Roman Gebauer, Tammo Delhaas, Frits W. Prinzen, Miroslav Krejčíř, Peter Kubuš, Miroslav Ložek, Viktor Tomek |
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| Přispěvatelé: | RS: CARIM - R2.09 - Cardiovascular system dynamics, Biomedische Technologie, Fysiologie, RS: CARIM - R2.08 - Electro mechanics |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Cardiac Catheterization Time Factors CARDIAC-RESYNCHRONIZATION medicine.medical_treatment Ventricular Dysfunction Right cardiac resynchronization therapy CHILDREN 030204 cardiovascular system & hematology right ventricle THERAPY VALVE-REPLACEMENT Electrocardiography 0302 clinical medicine FAILING RIGHT VENTRICLE echocardiography 030212 general & internal medicine tetralogy of Fallot Child Cardiac catheterization Tetralogy of Fallot medicine.diagnostic_test DYSSYNCHRONY Right bundle branch block heart defects congenital Biomechanical Phenomena Treatment Outcome Cardiology heart defects Female Cardiology and Cardiovascular Medicine Electrophysiologic Techniques Cardiac BUNDLE-BRANCH BLOCK medicine.medical_specialty Adolescent pediatrics Cardiac resynchronization therapy 03 medical and health sciences QRS complex Internal medicine medicine.artery medicine Humans Radiology Nuclear Medicine and imaging Cardiac Surgical Procedures Echocardiography Doppler Pulsed Bundle branch block FALLOT REPAIR business.industry Hemodynamics congenital Recovery of Function ADULTS medicine.disease Myocardial Contraction Pulmonary artery Ventricular Function Right TETRALOGY business |
| Zdroj: | Circulation-Cardiovascular Imaging, 10(9):006424. LIPPINCOTT WILLIAMS & WILKINS |
| ISSN: | 1941-9651 |
| DOI: | 10.1161/circimaging.117.006424 |
| Popis: | 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 P =0.002), pulmonary artery velocity time integral ( P =0.006), and RV maximum +dP/dt ( P P =0.006). RV mechanical synchrony improved: septal-to-lateral RV mechanical delay decreased ( P P =0.001). 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. |
| Databáze: | OpenAIRE |
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