Cardiac Resynchronization Therapy Optimization in a Patient with Left Ventricular Non-Compaction Cardiomyopathy and Morbid Obesity.

Figures

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  Figure 1. Diagnostic coronary angiography demonstrating unobstructed coronary arteries. Left panel: right coronary artery. Right panel: left coronary system with patent left main stem, left anterior descending, and left circumflex arteries

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  Figure 2.1. Device electrograms during tachycardia episodes illustrating dual arrhythmia mechanism. (A) Initial supraventricular tachycardia with atrial activity exceeding ventricular activity. (B) Transition to organized ventricular tachycardia with change in near-field electrogram morphology. (C-G) Failed antitachycardia pacing attempts followed by successful termination with ICD shock.

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  Figure 2.2. Monomorphic ventricular tachycardia, heart rate 210 bpm, LBBB morphology, Indeterminate axis in the inferior leads in keeping with mid-septal LV scar with a mid RV septal endocardial

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  Figure 2.3. Left bundle branch block morphology, atrial tachycardia with an atrial cycle length of aproximately 450ms, QRS duration 180ms.

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  Figure 3. Electrocardiogram following atrioventricular node ablation demonstrating paced rhythm with improved ventricular synchrony

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  Figure 4. A: Parasternal long axis view and apical 4 chamber view showing moderate mitral regurgitation pre echo-guided CRT optimization. B: Parasternal short axis and apical 4 chamber view after echo-guided CRT optimization showing mild mitral regurgitation. Poor image quailities due to body habitus.