A special case of ischemic dilated cardiomyopathy successfully treated by cardiac resynchronization therapy using a single-pass VDD defibrillator lead

Contact address: Prof. Dr. Sorin Pescariu, M.D., Ph.D., Cardiology Clinic, Institute of Cardiovascular Diseases, 13A, Gheorghe Adam Street, 300310, Timişoara, Romania, tel: +4 0256 207355 E-mail: [email protected] Abstract: We report the case of a 58-year-old man with ischemic dilated cardiomyopathy and a history of left ventricle geometrical reconstruction aft er apical aneurysm resection, treated by cardiac resynchronization therapy with the use of a single-pass VDD defi brillator lead. Th e intervention and fl uoroscopy time were prolonged by a diffi cult left ventricle lead placement, but the VDD lead contributed to time saving. Pacing and sensing thresholds as well as pacing and shock impedances were within normal limits. Th e benefi ts were important in terms of left ventricle systolic function and heart failure symptomatology aft er preexcitation of the left ventricle by 20 milliseconds. Adding cardiac resynchronization therapy to left ventricle reconstruction seems to have a benefi cial eff ect especially aft er optimizing the pacing parameters, to counteract the eff ects of the residual scar. On the other hand, implantation of triple chamber cardiac devices is a challenging intervention. Obtaining an effi cient cardiac resynchronization and primary sudden cardiac death prevention with two leads instead of three is feasible and it brings an important gain in terms of time saving and infection risk lowering. Data in the literature concerning these two issues is scarce.