Left ventricular epicardial pacing achieved hyper‐responsiveness in young children with dilated cardiomyopathy with left bundle branch block
Abstract Aims The management of heart failure (HF) in young children is challenging. The present study aimed to clarify the effect of left univentricular epicardial pacing on dilated cardiomyopathy with left bundle branch block (LBBB) in children. Methods and results A total of five cases (30.86 ± 1...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-12-01
|
| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13657 |
| _version_ | 1818208260358930432 |
|---|---|
| author | Sijuan Sun Xiaofeng Guo Yiwei Chen Jie Shen Diqi Zhu Zhifang Zhang Lijun Fu Wei Ji Fen Li |
| author_facet | Sijuan Sun Xiaofeng Guo Yiwei Chen Jie Shen Diqi Zhu Zhifang Zhang Lijun Fu Wei Ji Fen Li |
| author_sort | Sijuan Sun |
| collection | DOAJ |
| description | Abstract Aims The management of heart failure (HF) in young children is challenging. The present study aimed to clarify the effect of left univentricular epicardial pacing on dilated cardiomyopathy with left bundle branch block (LBBB) in children. Methods and results A total of five cases (30.86 ± 16.39 months, three female) of children weighing 5.8–15 kg with dilated cardiomyopathy and LBBB were included in this study. LBBB in one child occurred after device closure of peri‐membranous ventricular septal defects, and the remaining four were idiopathically discovered early after birth. Before implantation, all children suffered from refractory HF and cardiac dilatation; the left ventricular ejection fraction was 33.48 ± 5.84% with Ross Heart Failure Classification III–IV. Electrical and mechanical dyssynchrony were observed in all children with QRS duration >140 ms and prolonged septal‐to‐left posterior wall motion delay. Left univentricular epicardial pacing was successfully implanted via left axillary minithoracotomy in the five children. Sensed atrioventricular delays (83 ± 15 ms) were optimized by velocity time integral of aortic blood flow before discharge. During the follow‐up period (10.8 ± 2.68 months), the dilated failing heart was reversed significantly in terms of decreased left ventricular dimension (55.62 ± 3.46 vs. 38.94 ± 3.69 mm, P = 0.005), while the left ventricular ejection fraction improved to 60.18 ± 8.78% (P = 0.006). Conclusions In young children with low body weight, if HF is caused by or related to LBBB, left ventricular epicardial pacing still has an excellent effect. |
| first_indexed | 2024-12-12T04:41:59Z |
| format | Article |
| id | doaj.art-f73be844af004f1b87e3cf49e82fce75 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-12T04:41:59Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-f73be844af004f1b87e3cf49e82fce752022-12-22T00:37:46ZengWileyESC Heart Failure2055-58222021-12-01864772477910.1002/ehf2.13657Left ventricular epicardial pacing achieved hyper‐responsiveness in young children with dilated cardiomyopathy with left bundle branch blockSijuan Sun0Xiaofeng Guo1Yiwei Chen2Jie Shen3Diqi Zhu4Zhifang Zhang5Lijun Fu6Wei Ji7Fen Li8Department of Cardiology, Shanghai Children's Medical Center School of Medicine, Shanghai Jiao Tong University Shanghai 200127 ChinaDepartment of Cardiology Fujian Children's Hospital, Affiliated Hospital of Fujian Medical University Fuzhou ChinaDepartment of Cardiology, Shanghai Children's Medical Center School of Medicine, Shanghai Jiao Tong University Shanghai 200127 ChinaDepartment of Cardiology, Shanghai Children's Medical Center School of Medicine, Shanghai Jiao Tong University Shanghai 200127 ChinaDepartment of Cardiology, Shanghai Children's Medical Center School of Medicine, Shanghai Jiao Tong University Shanghai 200127 ChinaDepartment of Cardiology, Shanghai Children's Medical Center School of Medicine, Shanghai Jiao Tong University Shanghai 200127 ChinaDepartment of Cardiology, Shanghai Children's Medical Center School of Medicine, Shanghai Jiao Tong University Shanghai 200127 ChinaDepartment of Cardiology, Shanghai Children's Medical Center School of Medicine, Shanghai Jiao Tong University Shanghai 200127 ChinaDepartment of Cardiology, Shanghai Children's Medical Center School of Medicine, Shanghai Jiao Tong University Shanghai 200127 ChinaAbstract Aims The management of heart failure (HF) in young children is challenging. The present study aimed to clarify the effect of left univentricular epicardial pacing on dilated cardiomyopathy with left bundle branch block (LBBB) in children. Methods and results A total of five cases (30.86 ± 16.39 months, three female) of children weighing 5.8–15 kg with dilated cardiomyopathy and LBBB were included in this study. LBBB in one child occurred after device closure of peri‐membranous ventricular septal defects, and the remaining four were idiopathically discovered early after birth. Before implantation, all children suffered from refractory HF and cardiac dilatation; the left ventricular ejection fraction was 33.48 ± 5.84% with Ross Heart Failure Classification III–IV. Electrical and mechanical dyssynchrony were observed in all children with QRS duration >140 ms and prolonged septal‐to‐left posterior wall motion delay. Left univentricular epicardial pacing was successfully implanted via left axillary minithoracotomy in the five children. Sensed atrioventricular delays (83 ± 15 ms) were optimized by velocity time integral of aortic blood flow before discharge. During the follow‐up period (10.8 ± 2.68 months), the dilated failing heart was reversed significantly in terms of decreased left ventricular dimension (55.62 ± 3.46 vs. 38.94 ± 3.69 mm, P = 0.005), while the left ventricular ejection fraction improved to 60.18 ± 8.78% (P = 0.006). Conclusions In young children with low body weight, if HF is caused by or related to LBBB, left ventricular epicardial pacing still has an excellent effect.https://doi.org/10.1002/ehf2.13657Heart failureChildrenLeft bundle branch blockCardiomyopathyLeft univentricular pacing |
| spellingShingle | Sijuan Sun Xiaofeng Guo Yiwei Chen Jie Shen Diqi Zhu Zhifang Zhang Lijun Fu Wei Ji Fen Li Left ventricular epicardial pacing achieved hyper‐responsiveness in young children with dilated cardiomyopathy with left bundle branch block ESC Heart Failure Heart failure Children Left bundle branch block Cardiomyopathy Left univentricular pacing |
| title | Left ventricular epicardial pacing achieved hyper‐responsiveness in young children with dilated cardiomyopathy with left bundle branch block |
| title_full | Left ventricular epicardial pacing achieved hyper‐responsiveness in young children with dilated cardiomyopathy with left bundle branch block |
| title_fullStr | Left ventricular epicardial pacing achieved hyper‐responsiveness in young children with dilated cardiomyopathy with left bundle branch block |
| title_full_unstemmed | Left ventricular epicardial pacing achieved hyper‐responsiveness in young children with dilated cardiomyopathy with left bundle branch block |
| title_short | Left ventricular epicardial pacing achieved hyper‐responsiveness in young children with dilated cardiomyopathy with left bundle branch block |
| title_sort | left ventricular epicardial pacing achieved hyper responsiveness in young children with dilated cardiomyopathy with left bundle branch block |
| topic | Heart failure Children Left bundle branch block Cardiomyopathy Left univentricular pacing |
| url | https://doi.org/10.1002/ehf2.13657 |
| work_keys_str_mv | AT sijuansun leftventricularepicardialpacingachievedhyperresponsivenessinyoungchildrenwithdilatedcardiomyopathywithleftbundlebranchblock AT xiaofengguo leftventricularepicardialpacingachievedhyperresponsivenessinyoungchildrenwithdilatedcardiomyopathywithleftbundlebranchblock AT yiweichen leftventricularepicardialpacingachievedhyperresponsivenessinyoungchildrenwithdilatedcardiomyopathywithleftbundlebranchblock AT jieshen leftventricularepicardialpacingachievedhyperresponsivenessinyoungchildrenwithdilatedcardiomyopathywithleftbundlebranchblock AT diqizhu leftventricularepicardialpacingachievedhyperresponsivenessinyoungchildrenwithdilatedcardiomyopathywithleftbundlebranchblock AT zhifangzhang leftventricularepicardialpacingachievedhyperresponsivenessinyoungchildrenwithdilatedcardiomyopathywithleftbundlebranchblock AT lijunfu leftventricularepicardialpacingachievedhyperresponsivenessinyoungchildrenwithdilatedcardiomyopathywithleftbundlebranchblock AT weiji leftventricularepicardialpacingachievedhyperresponsivenessinyoungchildrenwithdilatedcardiomyopathywithleftbundlebranchblock AT fenli leftventricularepicardialpacingachievedhyperresponsivenessinyoungchildrenwithdilatedcardiomyopathywithleftbundlebranchblock |