Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2019; 7(3): 396-404
Published online Feb 6, 2019. doi: 10.12998/wjcc.v7.i3.396
Biventricular pacing for treating heart failure in children: A case report and review of the literature
Shan Yu, Qiang Wu, Bao-Lin Chen, Ya-Ping An, Jie Bu, Song Zhou, Yong-Mei Wang
Shan Yu, Qiang Wu, Bao-Lin Chen, Ya-Ping An, Jie Bu, Yong-Mei Wang, Department of Cardiology, Guizhou Provincial People’s Hospital, Guiyang 550002, Guizhou Province, China
Song Zhou, Department of Radiology, Guizhou Provincial People’s Hospital, Guiyang 550002, Guizhou Province, China
Author contributions: Yu S and Wu Q designed the study; Yu S, Chen BS, An YP, and Zhou S performed the experiments; Bu J and Wang YM performed statistical analyses; Yu S wrote the manuscript; WU Q revised the manuscript; all authors read and approved the final manuscript.
Supported by The Clinical Research Center Project of Department of Science and Technology of Guizhou Province, No. (2016)410 and No. (2017)5405.
Informed consent statement: The patient and his family members provided written informed consent.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The guidelines CARE Checklist (2016) have been adopted in this report
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qiang Wu, MD, PhD, Chief Doctor, Department of Cardiology, Guizhou Provincial People’s Hospital, No. 83, East Zhongshan Road, Guiyang 550002, Guizhou Province, China. gzgywq@126.com
Telephone: +86-138-09456742 Fax: +86-21-64085875
Received: November 21, 2018
Peer-review started: November 21, 2018
First decision: December 9, 2018
Revised: December 27, 2018
Accepted: January 8, 2019
Article in press: January 8, 2019
Published online: February 6, 2019
Abstract
BACKGROUND

Cardiac resynchronization therapy (CRT) can be used as an escalated therapy to improve heart function in patients with cardiac dysfunction due to long-term right ventricular pacing. However, guidelines are only targeted at adults. CRT is rarely used in children.

CASE SUMMARY

This case aimed to implement biventricular pacing in one child with heart failure who had a left ventricular ejection fraction < 35% at 4 years after implantation of an atrioventricular sequential pacemaker due to atrioventricular block. Postoperatively, echocardiography showed atrial sensing ventricular pacing and QRS wave duration of 120-130 ms, and cardiac function significantly improved after upgrading pacemaker.

CONCLUSION

Patients whose cardiac function is deteriorated to a level to upgrade to CRT should be upgraded to reverse myocardial remodeling as soon as possible.

Keywords: Artificial cardiac pacing, Atrioventricular block, Cardiac resynchronization therapy, Child, Heart failure, Case report

Core tip: Current guidelines are based on adults, which do not enroll pediatric patients for recommendation of cardiac resynchronization therapy, making it more difficult to accurately assess its curative effects. Moreover, the physiological characteristics of children cause a higher risk in surgery compared with adults. In January 2015, the Cardiology Department of Guizhou Provincial People's Hospital implemented biventricular pacing for the first time in one child with heart failure due to right ventricular pacing. The cardiac function of the child improved significantly after upgrading the pacemaker.