PMID- 17579245
OWN - NLM
STAT- MEDLINE
DCOM- 20080425
LR  - 20121115
IS  - 1099-5129 (Print)
IS  - 1099-5129 (Linking)
VI  - 9
IP  - 10
DP  - 2007 Oct
TI  - Non-contact mapping guided cardiac resynchronization therapy for a failing 
      systemic right ventricle.
PG  - 880-3
AB  - AIMS: Progressive systemic right ventricular (sRV) dysfunction, atrial and 
      ventricular arrhythmias and sudden cardiac death are well-recognized late 
      sequelae of atrial redirection surgery in which the right ventricle is left 
      connected to the systemic circulation. Although cardiac resynchronization therapy 
      (CRT) poses an attractive therapeutic option, little is known about indications, 
      patient selection, and technical aspects of best lead placement. METHODS AND 
      RESULTS: We undertook CRT in a 27-year-old female patient post-Mustard correction 
      for d-transposition (d-TGA) with New York Heart Association (NYHA) grade III 
      disability with QRS duration measuring 130 ms. There was also echocardiographic 
      (TTE) evidence of severe sRV dysfunction. Non-contact mapping (NCM) was used to 
      define sites of late activation within the sRV and the acute intra-arterial blood 
      pressure (BP) response was assessed during implantation of a 4 french (F) lead 
      onto the endocardial surface of the sRV. At 4 weeks post-implant sRV lateral wall 
      motion had improved and the ejection fraction (EF) rose from 23 to 33%. The 
      patient has been successfully anticoagulated and improved to NYHA II status after 
      6 months. CONCLUSION: The use of NCM proved safe and effective and provided a 
      qualitative assessment of electrical viability of the sRV complimenting the 
      measurement of mechanical function provided by TTE. The favourable clinical 
      response in the above case justifies a prospective evaluation of this strategy.
FAU - Michael, Kevin A
AU  - Michael KA
AD  - The Wessex Cardiothoracic Unit, Division of Clinical Electrophysiology, 
      Southampton University Hospitals NHS Trust, Southampton General Hospital, 
      Southampton SO16 6YD, Hampshire, UK. kevin_a_michael@yahoo.co.uk
FAU - Veldtman, Gruschen R
AU  - Veldtman GR
FAU - Paisey, John R
AU  - Paisey JR
FAU - Robinson, Stephen
AU  - Robinson S
FAU - Allen, Stuart
AU  - Allen S
FAU - Sunni, Nadia S
AU  - Sunni NS
FAU - Roberts, Paul R
AU  - Roberts PR
FAU - Morgan, John M
AU  - Morgan JM
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20070619
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Adult
MH  - Blood Pressure
MH  - Bradycardia/therapy
MH  - Cardiac Catheterization
MH  - Cardiac Pacing, Artificial/*methods
MH  - Equipment Design
MH  - Female
MH  - Heart Conduction System
MH  - Heart Failure/therapy
MH  - Heart Ventricles/pathology
MH  - Hemodynamics
MH  - Humans
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Right/*therapy
EDAT- 2007/06/21 09:00
MHDA- 2008/04/26 09:00
CRDT- 2007/06/21 09:00
PHST- 2007/06/21 09:00 [pubmed]
PHST- 2008/04/26 09:00 [medline]
PHST- 2007/06/21 09:00 [entrez]
AID - eum076 [pii]
AID - 10.1093/europace/eum076 [doi]
PST - ppublish
SO  - Europace. 2007 Oct;9(10):880-3. doi: 10.1093/europace/eum076. Epub 2007 Jun 19.