Why the study?
Does dual site right ventricular pacing provide similar symptomatic improvement compared to cardiac resynchronisation therapy in a patient with pacing-induced congestive heart failure?
Does dual site right ventricular pacing provide similar symptomatic improvement compared to cardiac resynchronisation therapy in a patient with pacing-induced congestive heart failure?
Dual site right ventricular pacing may offer a viable alternative to cardiac resynchronisation therapy for symptomatic improvement in patients with pacing-induced heart failure when left ventricular pacing is not feasible.
May support dual-site RV pacing when CRT infeasible in pacing-induced HF; leaves open randomized confirmation of long-term benefit.
A 46-year-old male patient who had long-term right ventricular (RV) pacing for symptomatic complete heart block, initially by an epicardial, later with an endocardial pacing lead at the RV apex, developed congestive heart failure (CHF) and chronic atrial fibrillation 7 years following the pacemaker implantation and was medically treated. During follow-up, his pacemaker was upgraded to a cardiac resynchronisation therapy (CRT) device, because of uncontrolled CHF symptoms, New York Heart Association (NYHA) functional class IV, while on drugs. The patient's symptomatic status improved to NYHA functional class II with CRT. After 17 months of CRT, the battery became depleted, because of the high capture threshold of the left ventricular lead. The patient was then given dual site RV pacing (RV outflow tract+RV apex) in place of CRT, which showed similar efficacy at 12 weeks follow-up.
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SATISH et al. (2005) studied this question.
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