Cardiac resynchronization therapy in children with dilated cardiomyopathy: A case series

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• 作者：Abdulmohsen Al Fadley ; Waleed Al Manea ; Majid Al Fayyadh ; Mamdouh Al Ahmadi
• 刊名：Journal of the Saudi Heart Association
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：25
• 期：2
• 页码：115
• 全文大小：46 K

文摘

Introduction

Dilated cardiomyopathy in children is a serious disease with significant burden and poor outcome. Ventricular desynchrony can lead to dysfunction and dilated cardiomyopathy (DCM). For such patients, cardiac resynchronization therapy (CRT) is a proven form of therapy however; the role of CRT in children is not well studied.

Objective

We aim to describe our experience with CRT in children with poor ventricular function.

Methods

We retrospectively reviewed all pediatric pts who underwent CRT in our institute. Data collected include: demographics, CRT indication, pre and post CRT ventricular assessment using echocardiogram, and follow up clinical evaluation.

Results

Between 09/05 and 12/08, 19 pediatric pts median age 4 years (8months to 16 years) underwent CRT for DCM. The etiology of d DCM was chronic RV pacing with and without congenital heart disease (CHD) in 15 pts, myocarditis in 2, and post repair of CHD 2. The median duration of chronic RV pacing prior to CRT was 4yrs (1-11 yrs) and all developed DCM. One pt had transvenous approach while all other pts had epicardial leads for the left ventricular and atrium. All devices were CRT-P. After 22 months of median follow up (1-46 months), 13 pts improved clinically with or without associated LV remolding. Theremaining 6 pts did not respond to CRT.

Conclusion

CRT is a promising mode of therapy for a subgroup of pediatric patients with poor ventricular function. More studies are needed to identify those who will benefit the most from this mode of therapy.