Why the study?
Does CRT-D implantation improve symptoms and cardiac function in a patient with systemic right ventricular failure and wide QRS due to corrected transposition of the great arteries?
Does CRT-D implantation improve symptoms and cardiac function in a patient with systemic right ventricular failure and wide QRS due to corrected transposition of the great arteries?
CRT-D implantation may be a useful therapeutic approach for systemic right ventricular failure with wide QRS and atrial fibrillation in patients with corrected transposition of the great arteries.
May support CRT-D consideration in systemic RV failure with wide QRS; leaves open prospective confirmation in corrected transposition of the great arteries.
A 32-year-old man developed systemic right ventricular (RV) heart failure after ventricular septal defect (VSD) closure and tricuspid valve replacement for corrected transposition of the great arteries with VSD and Ebstein anomaly. He subsequently experienced RV failure with wide QRS and atrial fibrillation (AF). Because corrective surgery for this condition seemed over risky, we decided to perform cardiac resynchronization therapy with implantation of an implantable cardioverter defibrillator (CRT-D). After CRT-D device implantation, the patient showed improved performance status in terms of New York Heart Association functional class, B-type brain natriuretic peptide levels, RV ejection fraction and cardiac electrical rhythm. CRT-D implantation is a useful approach for systemic RV failure with wide QRS duration showing right bundle branch block and AF.
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Fujii et al. (2010) studied this question.
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