[CRT-FORUM] 39S 4 years old girl, with a Dilated Cardiomiopathy. Dr. Rodriguez Artuza

[CRT-INFO]

Greetings for everyone! Thank you for being able to share this symposium and
I ask the permission of the moderator to express my opinion.

Dear Dr. Pedro:
It would be important to know the location of the Wolf, since it has been
described that some right anomalous pathways may cause left ventricular
dysfunction. It is likely that Dr. Perez Riera may send scientific
literature, since I don't remember the literature exactly now, but in the
last Cardiostim some topics were commented about this, so that if it is
right, ablation should be conducted; it is an interesting option, and there
would be no need to implant the resynchronizer, mainly if the patient goes
back to sinus rhythm with NARROW QRS. There are patients that recover their
ventricular function subsequent to ablation. If the Wolf is left, I would
not implant a resynchronizer, since the patient already has a left
ventricular pacing, if you ablate and she goes back to sinus with NARROW
QRS, there is no indication for the resynchronizer.
Our experience (although not so extensive) with resynchronizers in children
younger than 12 years old, is of a bad prognosis in a 1-year follow up.
Resynchronization in pediatrics is still controversial, since in the great
studies pediatric patients were not included.

Dr Carlos Rodriguez Artuza /Electrofisiologo Intervencionista IECTAS
Maracaibo-Venezuela

>
>> COLLEAGUES OF THE CRT SYMPOSIUM : My name is Pedro de la Paz, a 
>> pediatric cardiologist of Matanzas, Cuba. I would ask you about a 4 
>> years old girl, with a Dilated Cardiomiopathy, symptomatic (class 
>> II-III NYHA) with severe depressed LVEF, less than 30%, under 
>> treatment with furosemide, spironolactone, captopril and carvedilol,  
>> a WPW syndrome and a simple sinusal arrhythmia (probable sinus node 
>> dysfunction),  is it possible to consider the electrical device 
>> implantation (PM), to improve her VI disfunction ?
>>
>> thanks Dr Pedro (Cuba)
>>
>
>


-- 
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee