Successful Cardiac Resynchronization Therapy in a 3-Year-Old Girl With Isolated Left Ventricular Non-Compaction and Narrow QRS Complex : A Case Report
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概要
- 論文の詳細を見る
Cardiac resynchronization therapy (CRT) is a new method of treatment for refractory heart failure. However, for children, its indication, efficacy, and long-term prognosis remain unclear. This study describes the use of CRT for a 3-year-old girl with intractable heart failure caused by isolated left ventricular non-compaction (LVNC) with narrow QRS complex. Echocardiography showed diffuse hypokinetic left ventricular (LV) wall motion (ejection fraction =29.3%) with dyssynchrony between the apex, posterior and lateral walls, where numerous prominent trabeculations existed, and severe mitral regurgitation. Biventricular resynchronization using epicardial pacing leads was performed under general anesthesia. Pacing sites for optimal synchronization in the ventricular walls where chosen using tissue Doppler imaging, and AV delay was adjusted to achieve maximal systolic blood pressure and maximal cardiac output. Over a follow-up period of 2 years, she exhibited significant and sustained improvement in LV function and clinical symptoms. BNP levels decreased from 1,960 to 82 pg/ml. QRS duration (103 ms) on ECG did not change after CRT. We conclude that pediatric CRT provides a highly useful adjunct for the treatment of heart failure, even in patients with a narrow QRS duration, and might improve the prognosis of patients with LVNC. (Circ J 2009; 73: 2173-2177)
- 社団法人 日本循環器学会の論文
- 2009-10-20
著者
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MIYAWAKI Toshio
Department of Pediatrics, Graduate School of Medicine, University of Toyama
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Watanabe Kazuhiro
Department of Cardiology, Nihon University Surugadai Hospital
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WATANABE Sayaka
Department of Pediatrics, School of Medicine, University of Toyama
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SAITO Kazuyoshi
Department of Pediatrics, School of Medicine, University of Toyama
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HIRONO Keiichi
Department of Pediatrics, School of Medicine, University of Toyama
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UESE Keiichiro
Department of Pediatrics, School of Medicine, University of Toyama
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ICHIDA Fukiko
Department of Pediatrics, School of Medicine, University of Toyama
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YOSHIMURA Naoki
Department of First Department of Surgery, Graduate School of Medicine, University of Toyama
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Watanabe Kazuhiro
Department Of Cardiology Resuscitation And Emergency Cardiovascular Care Surugadai Nihon University
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Miyawaki T
Department Of Dermatology Graduate School Of Medicine University Of Toyama
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IBUKI Keijirou
Department of Pediatrics, University of Toyama
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YASUKOUCHI Satoshi
Department of Pediatric Cardiology, Nagano Prefectural Children's Hospital
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Hirono Keiichi
Department Of Department Of Pediatrics Graduate School Of Medicine University Of Toyama
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Uese Kei-ichiro
Department Of Pediatrics School Of Medicine University Of Toyama
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Ichida Fukiko
Department Of Department Of Pediatrics Graduate School Of Medicine University Of Toyama
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Ichida Fukiko
Department Of Pediatrics Faculty Of Medicine University Of Toyama
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Ibuki Keijirou
Department Of Pediatrics University Of Toyama
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Yoshimura Naoki
Department Of First Department Of Surgery Graduate School Of Medicine University Of Toyama
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Yoshimura Naoki
Department Of Cardiothoracic Surgery Kobe Children's Hospital
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Miyawaki Toshio
Department Of Dermatology Graduate School Of Medicine University Of Toyama
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Ichida Fukiko
The Gene Cardiovascular Disease Epidemiology Committee Of Japanese Pediatric Cardiology And Cardiac
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Saito Kazuyoshi
Department Of Agricultural Chemistry Kyoto University
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Miyawaki Toshio
Department Of Department Of Pediatrics Graduate School Of Medicine University Of Toyama
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Watanabe Sayaka
Department Of Pediatrics School Of Medicine University Of Toyama
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Yasukouchi Satoshi
Department Of Pediatric Cardiology Nagano Prefectural Children's Hospital
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Watanabe Kazuhiro
Department Of Pediatrics School Of Medicine University Of Toyama
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Watanabe Kazuhiro
Department Of Anesthesiology And Critical Care Medicine University Of Tsukuba
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Ichida Fukiko
The Gene Cardiovascular Disease Epidemiology Committee Of Japanese Pediatric Cardiology And Cardiac
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Ichida Fukiko
The Gene Cardiovascular Disease Epidemiology Committee Of Japanese Pediatric Cardiology And Cardiac
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Miyawaki Toshio
Department Of Pediatrics School Of Medicine Toyama Medical And Pharmaceutical University
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Watanabe Sayaka
Department of Pathological Biochemistry, Faculty of Pharmaceutical Sciences, Setsunan University
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