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Menon D, Aggarwal S, Kadiu G, Zelin KM, Karpawich PP. Assessing Non-invasive Studies to Evaluate Resynchronization Pacing Effectiveness in the Young. Pediatr Cardiol 2024; 45:867-875. [PMID: 36063175 DOI: 10.1007/s00246-022-02996-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/22/2022] [Indexed: 11/28/2022]
Abstract
Appropriate non-invasive assessments (ECHO/ECG) of cardiac resynchronization pacing therapy (CRT) among younger patients (pts) with/without (w/wo) congenital heart disease (CHD) are not established. Ejection fraction (EF) and QRS can be unreliable due to anatomy, surgical repairs, and pre-existing pacemakers (PM). This study correlates updated non-invasive studies, including newer strain values, with clinical and invasive hemodynamic assessments of CRT response in the young. Sixteen pts (mean age 18.5 ± 6 years, 10/16 with pre-existing pacemakers) underwent CRT for heart failure (NYHA II-III). CHD included septal defects and Tetralogy of Fallot. Assessment of CRT efficacy was based on clinical findings, direct catheterization studies [pressures, contractility indices (dP/dt-max)], ECG changes, and ECHO studies [including updated global (GLS), left atrial strain (LAS), and sphericity indices] pre- and at 1-month and 1-year post-CRT. After 1 year following CRT, all pts improved (II-III to I-II) in clinical NYHA status. Contractility (dP/dt) increased (932 ± 351 vs 561 ± 178.7 mmHg-sec [p = 0.001]). QRS duration shortened only among pts with pre-existing PM (160 ± 25 vs 134 ± 25 ms [p = 0.02]). Standard ECHO parameters, including chamber dimensions and EF, showed no appreciable changes from pre-CRT values. However, endocardial GLS [(- 6.4 vs. - 9.6%) p = 0.0003] and LAS [(- 5.8 vs - 9.3%) p = 0.02] values significantly improved. Although CRT is applicable to younger pts, accurate non-invasive evaluations of response are lacking. This study establishes that newer strain values better correlate with clinical and hemodynamic changes over other parameters and offer more appropriate assessments of CRT response.
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Affiliation(s)
- Dipika Menon
- Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State and Central Michigan University Schools of Medicine, Detroit, MI, USA
| | - Sanjeev Aggarwal
- Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State and Central Michigan University Schools of Medicine, Detroit, MI, USA
| | - Gilda Kadiu
- Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State and Central Michigan University Schools of Medicine, Detroit, MI, USA
| | - Kathleen M Zelin
- Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State and Central Michigan University Schools of Medicine, Detroit, MI, USA
| | - Peter P Karpawich
- Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State and Central Michigan University Schools of Medicine, Detroit, MI, USA.
- Section of Cardiology, The Children's Hospital of Michigan, 4Th Floor Carls, 3901 Beaubien St, Detroit, MI, 48201, USA.
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To go left or right? Driving towards the best direction in paediatric pacing. Cardiol Young 2022; 33:760-765. [PMID: 35673795 DOI: 10.1017/s1047951122001688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Permanent pacing in children with isolated congenital complete atrioventricular block may cause left ventricular dysfunction. To prevent it, alternative pacing sites have been proposed: left ventricular epicardial or selective right ventricular endocardial pacing. AIMS To compare the functional outcome (left ventricular systolic function and synchrony) in paediatric patients with congenital complete atrioventricular block and left ventricular apical epicardial or right ventricular transvenous mid-septal pacing. METHODS Retrospective study. Epicardial leads were implanted by standard surgical technique, transvenous leads by 3D electroanatomic mapping systems. 3D mapping acquired 3D right ventricular local pacing map and defined the narrowest paced QRS site. 3D mapping guided screw-in bipolar leads on that ventricular site. Electrocardiogram (ECG) (QRS duration) and echocardiographic data (synchrony: interventricular mechanical delay, septal to posterior wall motion delay, systolic dyssynchrony index; contractility: global longitudinal strain, ejection fraction) were recorded. Data are reported as median [interquartile ranges]. p < 0.05 was significant. RESULTS There were 19 transvenous systems (age 8.8 [6-14] years; right ventricular mid-septum) and 17 epicardial systems (0.04 [0.001-0.6] years; left ventricular apex). Post-implantation QRS significantly widened either in endocardial or in epicardial patients. Most patients reached 4-year follow-up. One-year and 4-year ejection fraction and global longitudinal strain were mostly within normal limits and did not show significant differences between the two groups and between the same endocardial/epicardial group. Synchrony parameters were within normal limits in the two groups. CONCLUSIONS Left ventricular apical epicardial pacing and 3D mapping-guided right ventricular mid-septal pacing preserved left ventricular contractility and synchrony in children and adolescents with congenital complete atrioventricular block at short-/mid-term follow-up, without relevant significant differences between the two groups.
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Pourier MS, Dull MM, Weijers G, Loonen J, Bellersen L, de Korte CL, Kapusta L, Mavinkurve-Groothuis AMC. Left ventricular dyssynchrony in long-term childhood cancer survivors treated with anthracyclines: a retrospective cross-sectional study. Int J Cardiovasc Imaging 2021; 37:3469-3475. [PMID: 34357522 PMCID: PMC8604879 DOI: 10.1007/s10554-021-02347-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to investigate left ventricular contraction patterns in asymptomatic Childhood cancer survivors (CCS) using two-dimensional speckle tracking echocardiography (2DSTE). Left ventricular longitudinal and circumferential myocardial parameters were assessed using 2DSTE, in asymptomatic CCS and age matched healthy controls. Time to peak (T2P) systolic strain was quantified. Dyssynchrony index (DI) was measured by calculating the standard deviation of T2P systolic strain of six segments in each view. Difference between T2P systolic longitudinal strain of septal and lateral wall was also assessed as a parameter for dyssynchrony. We included 115 CCS with a median age of 17.2 years (range 5.6–39.5) and a median follow up of 11.3 years (range 4.9–29.5) and 119 controls. Conventional echocardiographic parameters and global longitudinal strain were significantly decreased in CCS compared to controls (p < 0.01 and p = 0.02, respectively). Dyssynchrony index did not differ between CCS and controls. There was a clinically insignificant smaller absolute difference between T2P systolic longitudinal of septal and lateral wall in CCS compared to controls. We showed no difference in longitudinal or circumferential left ventricular dyssynchrony in CCS compared to controls using 2DSTE. Future research should focus on assessing dyssynchrony in more segments and a larger CCS population, using both 2D and 3DSTE.
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Affiliation(s)
- Milanthy S Pourier
- Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands. .,Department of Radiology and Nuclear Medicine, Medical UltraSound Imaging Centre (MUSIC), Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Myrthe M Dull
- Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gert Weijers
- Department of Radiology and Nuclear Medicine, Medical UltraSound Imaging Centre (MUSIC), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jacqueline Loonen
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Louise Bellersen
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chris L de Korte
- Department of Radiology and Nuclear Medicine, Medical UltraSound Imaging Centre (MUSIC), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Livia Kapusta
- Pediatric Cardiology Unit, Tel-Aviv Sourasky Medical Center, Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel.,Department of Pediatric Cardiology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
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Cardiac resynchronization therapy in paediatric patients with congenital heart disease: single centre with 10 years of experience. Cardiol Young 2021; 31:940-948. [PMID: 33500007 DOI: 10.1017/s1047951120004795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES In recent years, cardiac resynchronization therapy (CRT) has also started to be performed in the paediatric and CHD population. This study aimed to evaluate the efficacy of CRT in children with CHD. PATIENTS AND METHODS Patients with CHD who underwent CRT treatment in our paediatric cardiology clinic between January, 2010 and January, 2020 were included in the study. Demographic findings, 12-lead electrocardiograms, echocardiograms, clinical characteristics, management strategies, and outcomes were reviewed systematically. RESULTS The study population consisted of 18 CHD patients who had been treated with CRT for 10 years in our institution. The median age was 11 years (2.2-18 years) and the median weight was 39 kg (10-81 kg). Systemic ventricle was left ventricle in 13 patients, right ventricle in 4 patients, and 1 patient had single-ventricle physiology. CRT implantation indications were as follows: dysfunction after permanent pacemaker in 11 patients, dysfunction after left bundle branch block in 4 patients, and systemic ventricular dysfunction in 3 patients. CRT implantation techniques were epicardial (n = 13), hybrid (n = 4), and transvenous (n = 1) methods. QRS duration significantly decreased after CRT implantation (160 versus 124 m/second, p < 0.05). Median systemic ventricle ejection fraction (EF) significantly increased after the procedure (30 versus 50%, p < 0.05). Fourteen patients (78%) were responders, two patients (11%) were superresponders, and two patients (11%) were non-responders after the CRT treatment. One patient deceased during follow-up. Median follow-up duration was 40 months (6-117 months). CONCLUSION When electromechanical dyssynchrony occurs in paediatric cases with CHD and developing heart failure, patients should be evaluated in terms of CRT to improve ventricular function. Alternative CRT therapy will be beneficial in these cases that do not improve clinically despite optimal medical treatment.
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Kubuš P, Rubáčková Popelová J, Kovanda J, Sedláček K, Janoušek J. Long-Term Outcome of Patients With Congenital Heart Disease Undergoing Cardiac Resynchronization Therapy. J Am Heart Assoc 2021; 10:e018302. [PMID: 33719495 PMCID: PMC8174233 DOI: 10.1161/jaha.120.018302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Cardiac resynchronization therapy (CRT) is rarely used in patients with congenital heart disease, and reported follow‐up is short. We sought to evaluate long‐term impact of CRT in a single‐center cohort of patients with congenital heart disease. Methods and Results Thirty‐two consecutive patients with structural congenital heart disease (N=30) or congenital atrioventricular block (N=2), aged median of 12.9 years at CRT with pacing capability device implantation, were followed up for a median of 8.7 years. CRT response was defined as an increase in systemic ventricular ejection fraction or fractional area of change by >10 units and improved or unchanged New York Heart Association class. Freedom from cardiovascular death, heart failure hospitalization, or new transplant listing was 92.6% and 83.2% at 5 and 10 years, respectively. Freedom from CRT complications, leading to surgical system revision (elective generator replacement excluded) or therapy termination, was 82.7% and 72.2% at 5 and 10 years, respectively. The overall probability of an uneventful therapy continuation was 76.3% and 58.8% at 5 and 10 years, respectively. There was a significant increase in ejection fraction/fractional area of change (P<0.001) mainly attributable to patients with systemic left ventricle (P=0.002) and decrease in systemic ventricular end‐diastolic dimensions (P<0.05) after CRT. New York Heart Association functional class improved from a median 2.0 to 1.25 (P<0.001). Long‐term CRT response was present in 54.8% of patients at last follow‐up and was more frequent in systemic left ventricle (P<0.001). Conclusions CRT in patients with congenital heart disease was associated with acceptable survival and long‐term response in ≈50% of patients. Probability of an uneventful CRT continuation was modest.
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Affiliation(s)
- Peter Kubuš
- Children's Heart Centre 2nd Faculty of Medicine Charles University in Prague and Motol University Hospital Prague Czech Republic
| | | | - Jan Kovanda
- Children's Heart Centre 2nd Faculty of Medicine Charles University in Prague and Motol University Hospital Prague Czech Republic
| | - Kamil Sedláček
- Cardiology Department Institute for Clinical and Experimental Medicine Prague Czech Republic
| | - Jan Janoušek
- Children's Heart Centre 2nd Faculty of Medicine Charles University in Prague and Motol University Hospital Prague Czech Republic
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Silvetti MS, Pazzano V, Battipaglia I, Saputo FA, Mizzon C, Gimigliano F, Ammirati A, Ravà L, Drago F. Three-dimensional guided selective right ventricular septal pacing preserves ventricular systolic function and synchrony in pediatric patients. Heart Rhythm 2020; 18:434-442. [PMID: 33307214 DOI: 10.1016/j.hrthm.2020.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/11/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Nonfluoroscopic 3-dimensional (3D) electroanatomic mapping systems (EAMs) have been developed to guide cardiac catheter navigation and reduce fluoroscopy. Selective right ventricular (RV) septal pacing could prevent pacing-induced left ventricular (LV) dysfunction. OBJECTIVE The purpose of this study was to determine whether EAM-guided selective RV septal pacing preserves LV contractility/synchrony in pediatric patients with complete atrioventricular block (CAVB) and no other congenital heart defects. METHODS Prospective analysis of children/adolescents who underwent EAM-guided selective RV pacing was performed. A 3D pacing map guided ventricular lead implantation at septal sites with narrow paced QRS. Serial echocardiograms were obtained after pacemaker implantation to monitor for function (volumes, ejection fraction [EF], global longitudinal/circumferential strain) and synchrony (interventricular mechanical delay, septal to posterior wall motion delay, systolic dyssynchrony index). Data are reported as median (25th-75th percentile). RESULTS Thirty-two CAVB patients (age 9.8 [7.0-14.0] years; 11 with a previous pacing system) underwent selective RV septal pacing (13 DDD, 19 VVIR pacemaker; midseptum 22, parahisian 7, RV outflow tract 3) with narrow paced QRS (110 [100-120] ms) and low radiation exposure. Follow-up over 24 (5-33) months showed preserved LV function and synchrony, without significant differences between pacing sites (midseptum-parahisian) and mode (VVIR-DDD). EF decreased after implantation in patients without previous pacing, although values were mainly within normal limits. Three parahisian patients underwent early lead repositioning. CONCLUSION EAM-guided selective RV septal pacing is a feasible technique associated with preserved LV systolic function and synchrony and low radiation exposure in pediatric patients with CAVB.
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Affiliation(s)
- Massimo Stefano Silvetti
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy; European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart).
| | - Vincenzo Pazzano
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy; European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart)
| | - Irma Battipaglia
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy; European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart)
| | - Fabio Anselmo Saputo
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy; European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart)
| | - Chiara Mizzon
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy; European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart)
| | - Fabrizio Gimigliano
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy; European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart)
| | - Antonio Ammirati
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy; European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart)
| | - Lucilla Ravà
- Epidemiology Institute, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Fabrizio Drago
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy; European Reference Network for Rare and Low Prevalence Complex Disease of the Heart (ERN GUARD-Heart)
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Silvetti MS, Muzi G, Unolt M, D'Anna C, Saputo FA, Di Mambro C, Albanese S, Ammirati A, Ravà L, Drago F. Left ventricular (LV) pacing in newborns and infants: Echo assessment of LV systolic function and synchrony at 5‐year follow‐up. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2020; 43:535-541. [DOI: 10.1111/pace.13908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/10/2020] [Accepted: 03/15/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Massimo Stefano Silvetti
- Pediatric Cardiology and Cardiac Arrhythmias UnitDepartment of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children's Hospital and Research Institute Rome Italy
| | - Giulia Muzi
- Pediatric Cardiology and Cardiac Arrhythmias UnitDepartment of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children's Hospital and Research Institute Rome Italy
| | - Marta Unolt
- Pediatric Cardiology and Cardiac Arrhythmias UnitDepartment of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children's Hospital and Research Institute Rome Italy
| | - Carolina D'Anna
- Pediatric Cardiology and Cardiac Arrhythmias UnitDepartment of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children's Hospital and Research Institute Rome Italy
| | - Fabio Anselmo Saputo
- Pediatric Cardiology and Cardiac Arrhythmias UnitDepartment of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children's Hospital and Research Institute Rome Italy
| | - Corrado Di Mambro
- Pediatric Cardiology and Cardiac Arrhythmias UnitDepartment of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children's Hospital and Research Institute Rome Italy
| | - Sonia Albanese
- Cardiac Surgery UnitBambino Gesù Children's Hospital and Research Institute Rome Italy
| | - Antonio Ammirati
- Pediatric Cardiology and Cardiac Arrhythmias UnitDepartment of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children's Hospital and Research Institute Rome Italy
| | - Lucilla Ravà
- Epidemiology UnitBambino Gesù Children's Hospital and Research Institute Rome Italy
| | - Fabrizio Drago
- Pediatric Cardiology and Cardiac Arrhythmias UnitDepartment of Pediatric Cardiology and Cardiac SurgeryBambino Gesù Children's Hospital and Research Institute Rome Italy
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Ventricular interactions and electromechanical dyssynchrony after Ross and Ross-Konno operations. J Thorac Cardiovasc Surg 2019; 158:509-517. [DOI: 10.1016/j.jtcvs.2019.02.057] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/06/2019] [Accepted: 02/11/2019] [Indexed: 11/18/2022]
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Cassalett-Bustillo G. Falla cardíaca en pacientes pediátricos. Fisiopatología y tratamiento. Parte II. REVISTA COLOMBIANA DE CARDIOLOGÍA 2018. [DOI: 10.1016/j.rccar.2018.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Silvetti MS, Battipaglia I, Pazzano V, Saputo FA, Ravà L, Ammirati A, Calvieri C, Ciani M, Drago F. Electroanatomic mapping-guided localization of alternative right ventricular septal pacing sites in children. Pacing Clin Electrophysiol 2018; 41:1204-1211. [DOI: 10.1111/pace.13447] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 05/30/2018] [Accepted: 07/03/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Massimo Stefano Silvetti
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit; Bambino Gesù Children's Hospital and Research Institute; Rome Italy
| | - Irma Battipaglia
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit; Bambino Gesù Children's Hospital and Research Institute; Rome Italy
| | - Vincenzo Pazzano
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit; Bambino Gesù Children's Hospital and Research Institute; Rome Italy
| | - Fabio Anselmo Saputo
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit; Bambino Gesù Children's Hospital and Research Institute; Rome Italy
| | - Lucilla Ravà
- Epidemiology Unit; Bambino Gesù Children's Hospital and Research Institute; Rome Italy
| | - Antonio Ammirati
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit; Bambino Gesù Children's Hospital and Research Institute; Rome Italy
| | - Camilla Calvieri
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit; Bambino Gesù Children's Hospital and Research Institute; Rome Italy
| | | | - Fabrizio Drago
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit; Bambino Gesù Children's Hospital and Research Institute; Rome Italy
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Shiina Y, Inai K, Takahashi T, Taniguchi K, Watanabe E, Fukushima K, Niwa K, Nagao M. Inter- and intra-ventricular dyssynchrony in the systemic right ventricle is a surrogate marker of major cardiac events in mildly symptomatic patients. Heart Vessels 2018; 33:1086-1093. [DOI: 10.1007/s00380-018-1144-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 02/23/2018] [Indexed: 11/28/2022]
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Phenotype, management and predictors of outcome in a large cohort of adult congenital heart disease patients with heart failure. Int J Cardiol 2018; 252:80-87. [DOI: 10.1016/j.ijcard.2017.10.086] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 10/13/2017] [Accepted: 10/23/2017] [Indexed: 11/18/2022]
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Silvetti MS, Ammirati A, Palmieri R, Pazzano V, Placidi S, Ravà L, Remoli R, Saputo FA, Verticelli L, Drago F. What endocardial right ventricular pacing site shows better contractility and synchrony in children and adolescents? PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2017; 40:995-1003. [PMID: 28744930 DOI: 10.1111/pace.13153] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 05/09/2017] [Accepted: 06/27/2017] [Indexed: 11/28/2022]
Abstract
AIMS Right ventricular (RV) apical (RVA) pacing can induce left ventricular (LV) dyssynchrony, remodeling, and dysfunction in children with complete atrioventricular block (CAVB). We compared the functional outcome of RVA with RV alternative pacing sites (RVAPS), including para-Hisian, septal, and outflow tract sites. METHODS This is a single-center, retrospective study. Data were collected before pacemaker implantation (transvenous leads), postoperatively, at 6 months, and at 1-2-3-4 years. Electrocardiogram evaluation included QRS duration, axis, QTc/JTc, and QTc dispersion. Echocardiographic evaluation included 2-D/3-D assessment of ventricular dimensions (Z-score of LV end-diastolic dimension), function (ejection fraction), and synchrony. RESULTS From 2009 to 2015, 55 patients with CAVB, aged 3-17 years, with or without other congenital heart defects, underwent RVAPS (30 patients, median age 11 years) or RVA (25 patients, median 12 years). All leads were positioned into the septum. Before implantation, no significant differences in parameters were observed, except for higher Z-score in RVAPS than in RVA. After implantation, at a median follow-up of 2.5 (range 1-6) years, the two groups showed no significant differences in LV dimensions, contractility, and synchrony. QRS intervals of RVAPS were significantly shorter than RVA. Clinical status was good and contractility/synchrony indexes were normal or adequate in all patients. CONCLUSIONS In pediatric patients, RVAPS and RVA showed no significant differences in LV dimensions, contractility, and synchrony. Preimplantation dilated patients showed LV reverse remodeling. RVAPS demonstrated shorter QRS intervals. Therefore, septal pacing sites, either RVA or RVAPS, seem to determine good contractility and synchrony at a mid-term follow-up.
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Affiliation(s)
- Massimo Stefano Silvetti
- Pediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Antonio Ammirati
- Pediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Rosalinda Palmieri
- Pediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Vincenzo Pazzano
- Pediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Silvia Placidi
- Pediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Lucilla Ravà
- Epidemiology Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Romolo Remoli
- Pediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Fabio Anselmo Saputo
- Pediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Letizia Verticelli
- Pediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Fabrizio Drago
- Pediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
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Karpawich PP, Bansal N, Samuel S, Sanil Y, Zelin K. 16 Years of Cardiac Resynchronization Pacing Among Congenital Heart Disease Patients: Direct Contractility (dP/dt-max) Screening When the Guidelines Do Not Apply. JACC Clin Electrophysiol 2017; 3:830-841. [PMID: 29759779 DOI: 10.1016/j.jacep.2017.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 12/29/2016] [Accepted: 01/12/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The purpose of this study was to use direct cardiac resynchronization therapy (CRT)-paced contractility (dP/dt-max) response as a pre-implantation evaluation among patients with congenital heart disease (CHD) and follow clinical parameters and contractility indexes after CRT implantation. BACKGROUND Patients with CHD often develop early heart failure with few therapeutic options, leading to heart transplantation (HT). Unfortunately, guidelines for CRT do not apply, and function evaluations by cardiac ultrasound are often inaccurate among CHD anatomies. Therefore, which CHD patients would benefit from CRT remains an enigma. METHODS From 1999 to 2015, 103 CHD patients with New York Heart Association (NYHA) functional class II to IV were listed for HT; 40 patients on optimal medical therapy were referred for paced contractility response cardiac catheterization before CRT consideration. If dP/dt-max improved ≥15% from baseline, these "responders" were given the option of CRT with continued follow-up after implantation. RESULTS Of 40 patients studied, 26 (65%) (age 22 ± 8.2 years; 9 of 26 [35%] single or systemic right ventricle; 17 of 26 [65%] with pacemakers) met criteria for possible hemodynamic benefit and underwent CRT implantation. All 26 patients improved in NYHA functional classification: 5 of 26 patients (19%) were later relisted for HT (4 to 144 months, mean 55 months) after CRT implantation, whereas 21 of 26 (81%) continued with improved NYHA functional class (12 to 112 months, mean 44 months) later. A repeat dP/dt-max study following long-term CRT showed stable function or continued contractility improvement. CONCLUSIONS Heart failure is common among CHD patients, and therapies are limited. CRT guidelines do not address clinical and anatomic issues of CHD. Short-term paced contractility response testing identifies those CHD patients who are likely to respond to CRT regardless of anatomy.
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Affiliation(s)
- Peter P Karpawich
- Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan.
| | - Neha Bansal
- Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan
| | - Sharmeen Samuel
- Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan
| | - Yamuna Sanil
- Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan
| | - Kathleen Zelin
- Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan
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Kim HJ, Cho S, Kim WH. Cardiac Resynchronization Therapy Defibrillator Treatment in a Child with Heart Failure and Ventricular Arrhythmia. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2016; 49:292-4. [PMID: 27525239 PMCID: PMC4981232 DOI: 10.5090/kjtcs.2016.49.4.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 03/21/2016] [Accepted: 03/23/2016] [Indexed: 11/16/2022]
Abstract
Cardiac resynchronization therapy (CRT) is a new treatment for refractory heart failure. However, most patients with heart failure treated with CRT are adults, middle-aged or older with idiopathic or ischemic dilated cardiomyopathy. We treated a 12-year-old boy, who was transferred after cardiac arrest, with dilated cardiomyopathy, left bundle-branch block, and ventricular tachycardia. We performed cardiac resynchronization therapy with a defibrillator (CRT-D). After CRT-D, left ventricular ejection fraction improved from 22% to 44% assessed by echocardiogram 1 year postoperatively. On electrocardiogram, QRS duration was shortened from 206 to 144 ms. The patient’s clinical symptoms also improved. For pediatric patients with refractory heart failure and ventricular arrhythmia, CRT-D could be indicated as an effective therapeutic option.
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Affiliation(s)
- Hak Ju Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine
| | - Sungkyu Cho
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine
| | - Woong-Han Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine
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16
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Stout KK, Broberg CS, Book WM, Cecchin F, Chen JM, Dimopoulos K, Everitt MD, Gatzoulis M, Harris L, Hsu DT, Kuvin JT, Law Y, Martin CM, Murphy AM, Ross HJ, Singh G, Spray TL. Chronic Heart Failure in Congenital Heart Disease. Circulation 2016; 133:770-801. [DOI: 10.1161/cir.0000000000000352] [Citation(s) in RCA: 219] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekvål TM, Spaulding C, Van Veldhuisen DJ. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Europace 2015; 17:1601-87. [PMID: 26318695 DOI: 10.1093/europace/euv319] [Citation(s) in RCA: 217] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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19
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Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekvål TM, Spaulding C, Van Veldhuisen DJ. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J 2015; 36:2793-2867. [PMID: 26320108 DOI: 10.1093/eurheartj/ehv316] [Citation(s) in RCA: 2518] [Impact Index Per Article: 279.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
MESH Headings
- Acute Disease
- Aged
- Anti-Arrhythmia Agents/therapeutic use
- Arrhythmias, Cardiac/genetics
- Arrhythmias, Cardiac/therapy
- Autopsy/methods
- Cardiac Resynchronization Therapy/methods
- Cardiomyopathies/complications
- Cardiomyopathies/therapy
- Cardiotonic Agents/therapeutic use
- Catheter Ablation/methods
- Child
- Coronary Artery Disease/complications
- Coronary Artery Disease/therapy
- Death, Sudden, Cardiac/prevention & control
- Defibrillators
- Drug Therapy, Combination
- Early Diagnosis
- Emergency Treatment/methods
- Female
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/therapy
- Heart Transplantation/methods
- Heart Valve Diseases/complications
- Heart Valve Diseases/therapy
- Humans
- Mental Disorders/complications
- Myocardial Infarction/complications
- Myocardial Infarction/therapy
- Myocarditis/complications
- Myocarditis/therapy
- Nervous System Diseases/complications
- Nervous System Diseases/therapy
- Out-of-Hospital Cardiac Arrest/therapy
- Pregnancy
- Pregnancy Complications, Cardiovascular/therapy
- Primary Prevention/methods
- Quality of Life
- Risk Assessment
- Sleep Apnea, Obstructive/complications
- Sleep Apnea, Obstructive/therapy
- Sports/physiology
- Stroke Volume/physiology
- Terminal Care/methods
- Ventricular Dysfunction, Left/complications
- Ventricular Dysfunction, Left/therapy
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Abstract
Extrapolating cardiac resynchronization therapy (CRT) to pediatric patients with heart failure has at times been difficult given the heterogeneity of pediatric cardiomyopathies, varying congenital heart disease (CHD) substrates, and the fact that most pediatric heart failure patients have right bundle branch block (RBBB) as opposed to LBBB. Yet, despite these limitations a number of multi-center retrospective studies in North America and Europe have identified some data to suggest that certain sub-populations tend to respond positively to CRT. In order to address some of the heterogeneity it is helpful to subdivide pediatric and young adult patients with CHD into four potential groups: (1) CRT for chronic RV pacing, (2) dilated cardiomyopathies, (3) pulmonary right ventricles, and (4) systemic right ventricles. The chronic RV paced group, especially long-standing RV apical pacing, with ventricular dyssynchrony has consistently shown to be the group that best responds to a proactive resynchronization course. CRT therapy in pulmonary right ventricles such as post-op tetralogy of Fallot have shown some promise and may be considered especially if there is evidence of concomitant left ventricular dysfunction with an electrical dyssynchrony. Patients with systemic right ventricles such as post-atrial baffle surgery or congenitally corrected transposition reportedly do well with CRT in the presence of both inter-ventricular and intra-ventricular dyssynchrony. There is little doubt that moving forward to best way to identify which pediatric patients with heart failure will respond to CRT, will require a collaborative effort between the electrophysiologist and the echocardiographer to identify appropriate candidates with electrical and mechanical dyssynchrony.
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Bhatt AB, Foster E, Kuehl K, Alpert J, Brabeck S, Crumb S, Davidson WR, Earing MG, Ghoshhajra BB, Karamlou T, Mital S, Ting J, Tseng ZH. Congenital Heart Disease in the Older Adult. Circulation 2015; 131:1884-931. [DOI: 10.1161/cir.0000000000000204] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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22
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Abstract
A number of trials have shown that irrespective of baseline QRS duration, left ventricular (LV) dysfunction and heart failure are more common in patients with right ventricular (RV) than in those with biventricular (BiV) pacing. By contrast, preliminary results of the BIOPACE trial (follow-up 5.6 years) yielded a disappointing comparison of RV vs. BiV pacing. Pacemaker-induced cardiomyopathy (PIC) may occur in patients with normal and abnormal LV ejection fractions (LVEF) and tends to occur if there is RV pacing more than 40 % of the time. Yet, some pacemaker-dependent patients do not develop LV dysfunction. PIC can be improved in about two thirds of patients by upgrading to a BiV system and the results are comparable to de novo BiV pacing in patients with a wide QRS complex. The findings of the BLOCK HF trial (2013) suggested that patients requiring pacing virtually 100 % of the time might benefit from BiV pacing irrespective of the LVEF (< 50 %), manifestations of heart failure, QRS duration, or functional class. These characteristics would generate many patients for BiV pacing. However, these recommendations should now be weighed against a more conservative approach based on the recently announced results of the BIOPACE trial. Organizational guidelines recommend BiV pacing for bradycardia irrespective of QRS duration for patients with LVEF < 35 %. At this time, BiV pacing for antibradycardia therapy (irrespective of QRS duration) has to be individualized in the setting of a normal or decreased LVEF (> 35 %) and according to the expected percentage of RV pacing. The benefit of BiV pacing should be considered against procedural complications, which are more frequent than with traditional RV pacing.
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Affiliation(s)
- S Serge Barold
- Florida Heart Rhythm Institute, 5 Tampa General Circle, 33606, Tampa, FL, USA,
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23
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Biventricular pacing for bradycardia: Are we there yet? J Electrocardiol 2015; 48:236-40. [DOI: 10.1016/j.jelectrocard.2014.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Indexed: 11/22/2022]
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Guglin M, Barold SS. The role of biventricular pacing in the prevention and therapy of pacemaker-induced cardiomyopathy. Ann Noninvasive Electrocardiol 2015; 20:224-39. [PMID: 25564929 DOI: 10.1111/anec.12245] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Right ventricular (RV) pacing produces well-known long-term deleterious effects not only on already compromised, but also on the normal left ventricle (LV). The activation pattern mimicks that of left bundle branch block, with delayed activation of the LV free wall, and results in electrical and mechanical dyssynchrony. Long-term mandatory (100%) RV pacing, increases LV dimensions and decreases the ejection fraction. Many of these negative effects of pacing can be overcome by biventricular pacing. In this review, we describe the characteristics of pacemaker-induced cardiomyopathy, its incidence, and the use of cardiac resynchronization therapy (CRT) for its therapy and prevention. The gaps in the current organizational guidelines for using CRT in the treatment of bradycardia are identified, and goals for future research are discussed.
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Affiliation(s)
| | - S Serge Barold
- University of Rochester School of Medicine and Dentistry, Rochester, NY
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25
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Affiliation(s)
- Tomoko Ishizu
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
| | - Hitoshi Horigome
- Department of Child Health, Faculty of Medicine, University of Tsukuba
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26
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Forsha D, Slorach C, Chen CK, Stephenson EA, Risum N, Hornik C, Wagner G, Mertens L, Barker P, Kisslo J, Friedberg MK. Classic-Pattern Dyssynchrony and Electrical Activation Delays in Pediatric Dilated Cardiomyopathy. J Am Soc Echocardiogr 2014; 27:956-64. [DOI: 10.1016/j.echo.2014.06.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Indexed: 11/28/2022]
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27
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Silvetti MS, Di Carlo D, Ammirati A, Placidi S, Di Mambro C, Rava L, Drago F. Left ventricular pacing in neonates and infants with isolated congenital complete or advanced atrioventricular block: short- and medium-term outcome. Europace 2014; 17:603-10. [DOI: 10.1093/europace/euu180] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 06/10/2014] [Indexed: 11/14/2022] Open
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Abstract
Significant improvement in survival of children with congenital cardiac malformations has resulted in an increasing population of adolescent and adult patients with congenital heart disease. Of the long-term cardiac problems, ventricular dysfunction remains an important issue of concern. Despite corrective or palliative repair of congenital heart lesions, the right ventricle, which may be the subpulmonary or systemic ventricular chamber, and the functional single ventricle are particularly vulnerable to functional impairment. Regular assessment of cardiac function constitutes an important aspect in the long-term follow up of patients with congenital heart disease. Echocardiography remains the most useful imaging modality for longitudinal monitoring of cardiac function. Conventional echocardiographic assessment has focused primarily on quantification of changes in ventricular size and blood flow velocities during the cardiac cycles. Advances in echocardiographic technologies including tissue Doppler imaging and speckle tracking echocardiography have enabled direct interrogation of myocardial deformation. In this review, the issues of ventricular dysfunction in congenital heart disease, conventional echocardiographic and novel myocardial deformation imaging techniques, and clinical applications of these techniques in the functional assessment of congenital heart disease are discussed.
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Affiliation(s)
- Yiu-Fai Cheung
- Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
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29
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Krieger EV, Valente AM. Heart failure treatment in adults with congenital heart disease: where do we stand in 2014? Heart 2014; 100:1329-34. [DOI: 10.1136/heartjnl-2014-305667] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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30
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Barold SS, Herweg B. Will biventricular pacing replace right ventricular pacing for antibradycardia therapy? Expert Rev Med Devices 2014; 10:591-6. [DOI: 10.1586/17434440.2013.835552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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31
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Affiliation(s)
- Tsugutoshi Suzuki
- Department of Pediatric Electrophysiology, Pediatric Medical Care Center, Osaka City General Hospital
| | - Kyoichi Nishigaki
- Department of Pediatric Cardiovascular Surgery, Pediatric Medical Care Center, Osaka City General Hospital
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32
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Suzuki T, Sumitomo N, Yoshimoto J, Miyazaki A, Hinokiyama K, Ushinohama H, Yasukochi S. Current Trends in Use of Implantable Cardioverter Defibrillators and Cardiac Resynchronization Therapy With a Pacemaker or Defibrillator in Japanese Pediatric Patients. Circ J 2014; 78:1710-6. [DOI: 10.1253/circj.cj-13-1379] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tsugutoshi Suzuki
- Department of Pediatric Electrophysiology, Pediatric Medical Care Center, Osaka City General Hospital
| | - Naokata Sumitomo
- Department of Pediatrics Cardiology, Saitama Medical University International Medical Hospital
| | - Jun Yoshimoto
- Department of Pediatric Cardiology, Shizuoka Children’s Hospital
| | - Aya Miyazaki
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
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33
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Echocardiographic Follow-up of Grown-ups with Congenital Heart Disease: Update 2013. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013. [DOI: 10.1007/s12410-013-9236-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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34
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Padalino MA, Vida VL, Rito ML, Daliento L, Stellin G. The role of cardiac surgery in adult patients with congenital heart disease. J Cardiovasc Med (Hagerstown) 2013; 14:326-33. [DOI: 10.2459/jcm.0b013e3283542eec] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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35
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Tracy CM, Epstein AE, Darbar D, DiMarco JP, Dunbar SB, Estes NAM, Ferguson TB, Hammill SC, Karasik PE, Link MS, Marine JE, Schoenfeld MH, Shanker AJ, Silka MJ, Stevenson LW, Stevenson WG, Varosy PD, Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Creager MA, DeMets D, Ettinger SM, Guyton RA, Hochman JS, Kushner FG, Ohman EM, Stevenson W, Yancy CW. 2012 ACCF/AHA/HRS focused update of the 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg 2013; 144:e127-45. [PMID: 23140976 DOI: 10.1016/j.jtcvs.2012.08.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Takeuchi D, Tomizawa Y. Pacing device therapy in infants and children: a review. J Artif Organs 2012; 16:23-33. [PMID: 23104398 DOI: 10.1007/s10047-012-0668-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 10/10/2012] [Indexed: 01/20/2023]
Abstract
The number of pediatric pacemakers implanted is still relatively small. Children requiring pacing therapy have characteristics that are distinct from those of adults, including physical size, somatic growth, and cardiac anomalies. Considering these features, long-term follow-up of pediatric pacemaker implantation is necessary. Selection of appropriate generators, pacing modes, pacing sites, and leads is important. Generally, epicardial leads are commonly used in small infants. On the other hand, the use of endocardial leads in children is increasing worldwide because of their benefits over epicardial leads, such as minimal invasiveness, lower pacing threshold, and longer generator longevity. Endocardial leads are not suitable for patients with intracardiac shunts because of the high risk of systemic thrombosis. Venous occlusion is another significant problem with endocardial leads. With the increase in the number of pacing device implantations, the incidence of infection from such devices is also increasing. Complete device removal is sometimes recommended to treat device infection, but experience in the removal of endocardial leads in children is still scarce. This article gives an overview of pacing therapy in the pediatric population, including discussions on new pacing systems, such as remote monitoring systems, magnetic imaging compliant pacemaker systems, and leadless pacing devices.
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Affiliation(s)
- Daiji Takeuchi
- Department of Pediatric Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
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37
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Tracy CM, Epstein AE, Darbar D, Dimarco JP, Dunbar SB, Estes NAM, Ferguson TB, Hammill SC, Karasik PE, Link MS, Marine JE, Schoenfeld MH, Shanker AJ, Silka MJ, Stevenson LW, Stevenson WG, Varosy PD. 2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Heart Rhythm 2012; 9:1737-53. [PMID: 22975672 DOI: 10.1016/j.hrthm.2012.08.021] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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38
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Tracy CM, Epstein AE, Darbar D, Dimarco JP, Dunbar SB, Estes NAM, Ferguson TB, Hammill SC, Karasik PE, Link MS, Marine JE, Schoenfeld MH, Shanker AJ, Silka MJ, Stevenson LW, Stevenson WG, Varosy PD. 2012 ACCF/AHA/HRS focused update of the 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2012; 60:1297-313. [PMID: 22975230 DOI: 10.1016/j.jacc.2012.07.009] [Citation(s) in RCA: 229] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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39
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Tracy CM, Epstein AE, Darbar D, DiMarco JP, Dunbar SB, Estes NAM, Ferguson TB, Hammill SC, Karasik PE, Link MS, Marine JE, Schoenfeld MH, Shanker AJ, Silka MJ, Stevenson LW, Stevenson WG, Varosy PD, Ellenbogen KA, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hayes DL, Page RL, Stevenson LW, Sweeney MO. 2012 ACCF/AHA/HRS focused update of the 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. [corrected]. Circulation 2012; 126:1784-800. [PMID: 22965336 DOI: 10.1161/cir.0b013e3182618569] [Citation(s) in RCA: 239] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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ORTEGA MARTA, MERINO JOSELUISL, BLANCO FERNANDOV, GUTIÉRREZ-LARRAYA FEDERICO. Cardiac Resynchronization Therapy in an Infant with Double Outlet Right Ventricle and Mechanical Dyssynchrony. J Cardiovasc Electrophysiol 2012; 23:781-3. [DOI: 10.1111/j.1540-8167.2011.02282.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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