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European Journal of Echocardiography 2005 6(6):455-460; doi:10.1016/j.euje.2005.02.001
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Copyright © 2005, The European Society of Cardiology

Benefit of cardiac resynchronization therapy to a patient with a narrow QRS complex and ventricular dyssynchrony identified by tissue synchronization imaging*

Kaoru Dohi, Matthew Suffoletto, Srinivas Murali, Raveen Bazaz and John Gorcsan*

University of Pittsburgh, Scaife 564, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA

Received 14 December 2004; accepted after revision 6 February 2005.

gorcsanj{at}msx.upmc.edu

gorcsanj{at}upmc.edu

* Corresponding author. Tel.: +1 412 647 6570; fax: +1 412 647 0568.


  Abstract

This report described an 81-year-old woman with severe symptomatic heart failure, reduced ejection fraction, mitral regurgitation, and an electrocardiographic QRS width of 118ms who had ventricular dyssynchrony identified by echocardiographic tissue synchronization imaging. Because of her severe heart failure symptoms on maximal medical therapy, referral to implant a defibrillator, and mechanical dyssynchrony, she underwent cardiac resynchronization-defibrillator therapy with lateral left ventricular lead placement. This resulted in an immediate 30% increase in stroke volume and 35% decrease in mitral regurgitation. Echocardiographic tissue synchronization imaging may play a role in identifying mechanical dyssynchrony in patients with narrow QRS duration who may potentially benefit from cardiac resynchronization therapy.

Keywords: Heart failure; Narrow QRS; Mechanical dyssynchrony; Tissue synchronization imaging; Cardiac resynchronization therapy; Mitral regurgitation; Echocardiography; Pacing therapy; Doppler ultrasound

* Dr. Gorcsan was supported in part by N.I.H. awards K24 HL04503-01 and RO1 HL073198-01.


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