Why the study?
Most patients with pacing-induced cardiomyopathy improve with CRT, but a small percentage do not respond due to various factors.
Does RV lead revision to an apical location improve LVEF and symptoms in a patient with pacing-induced cardiomyopathy and CRT non-response due to RV free wall placement?
Does RV lead revision to an apical location improve LVEF and symptoms in a patient with pacing-induced cardiomyopathy and CRT non-response due to RV free wall placement?
This case highlights that RV free wall lead placement can cause lack of septal activation and CRT non-response, which may be successfully corrected by revising the lead to an apical position.
Answers are grounded in this paper and cite their sources.
CRT nonresponse persists despite optimal LV lead position in young patients; leaves open alternative strategies for pacing-induced cardiomyopathy.
Pacing induced cardiomyopathy is a known complication of high percent right ventricular (RV) pacing. When treated with cardiac resynchronization therapy (CRT), most patients experience recovery of Left Ventricular (LV) systolic function.A small percentage of patients do not respond due to a number of factors.This case examines the management of a 30-year-old patient with pacing induced cardiomyopathy who was found to be a CRT non responder despite optimalLV lead position and whose LV Ejection Fraction normalized followingRV lead revision.
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Tony et al. (2019) studied this question.
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