| Triple-site pacing: a new supported therapy approach for bridge to recovery with a left ventricular assist system in a patient with idiopathic dilated cardiomyopathy. | |
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MedLine Citation:
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PMID: 20174955 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Left ventricular assist devices (LVAD) are widely used as bridges to cardiac transplantation or for destination therapy. LVAD support may also function as a bridge to ventricular recovery, but a sufficient rate of recovery has not been obtained, even with various adjuvant therapies. Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure, and there is a report of successful weaning off LVAD with CRT. However, some patients with CRT could not improve their cardiac function because of residual dyssynchrony. Herein, we describe a case of a successful bridge to recovery with triple-site pacing for residual dyssynchrony after biventricular pacing. A 34-year-old woman with heart failure due to dilated cardiomyopathy whose condition deteriorated underwent Toyobo LVAD implantation, resulting in improvement of the left ventricular ejection fraction (LVEF) from 12 to 36%. Because of left ventricular dyssynchrony, we performed CRT, but residual dyssynchrony impeded cardiac recovery. We inserted an additional ventricular lead at the right ventricular outlet to achieve triple-site pacing in order to obtain complete synchronization. The LVEF improved to 45%, and the patient was successfully weaned off the LVAD. In LVAD-supported cases of persistent left ventricular dyssynchrony with CRT, implantation of triple-site pacing could potentially accelerate recovery. |
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Authors:
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Takashi Nishimura; Shunei Kyo |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-02-20 |
Journal Detail:
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Title: Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs Volume: 13 ISSN: 1619-0904 ISO Abbreviation: J Artif Organs Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-05 Completed Date: 2010-06-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9815648 Medline TA: J Artif Organs Country: Japan |
Other Details:
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Languages: eng Pagination: 54-7 Citation Subset: IM |
Affiliation:
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Division of Therapeutic Strategy for Heart Failure, Department of Cardiothoracic Surgery, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan. takashin-tky@umin.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cardiac Pacing, Artificial* Cardiomyopathy, Dilated / complications, surgery*, ultrasonography Female Heart Failure / etiology, surgery, ultrasonography Heart-Assist Devices* Humans Stroke Volume / physiology Treatment Outcome Ventricular Dysfunction, Left / surgery, ultrasonography |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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