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Home > Journals > Minerva Pediatrica > Past Issues > Minerva Pediatrica 2012 October;64(5) > Minerva Pediatrica 2012 October;64(5):451-60



A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry

Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,532

Frequency: Bi-Monthly

ISSN 0026-4946

Online ISSN 1827-1715


Minerva Pediatrica 2012 October;64(5):451-60


Echocardiography and cardiac resynchronization therapy in children and patients with congenital heart disease

Mertens L., Friedberg M. K.

Labatt Family Heart Center, Hospital for Sick Children, Toronto, ON, Canada

Cardiac resynchronization therapy (CRT) has been shown to improve mortality and morbidity in adults with refractory heart failure and prolonged QRS-duration. Recent research data suggest that the therapeutic benefit is related to the effect of CRT on interventricular and intraventricular dyssynchrony associated with electrical dyssynchrony. However, around 30-40% of the patients do not respond to CRT when device implantation is based only on QRS-duration. It was hoped that improved description of mechanical dyssynchrony using imaging techniques, might result in improved identification of patients who could benefit from CRT. Different methods have been proposed but a recent multicenter prospective echocardiographic study (PROSPECT) was disappointing. Applying adult criteria for CRT treatment to children and adults with acquired and congenital heart disease is even more challenging due to the age-dependency of QRS-duration and the wide variety of underlying diseases including different ventricular morphology that can result in heart failure. In this review we will overview the adult and pediatric data of CRT treatment and propose a mechanistic approach that could potentially be helpful in trying to identify those patients who might benefit from the treatment.

language: English


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