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Cardiac Resynchronization Therapy as Rescue Therapy in End‐Stage Heart Failure: Illustration by Three‐Dimensional Speckle Tracking Strain Echocardiography
Authors:Aurélie Guiot M.D.  Anne Laure Castel M.D.  Yves Guyomar M.D.  Estelle Cuvelier M.D.  François Delelis M.D.  Pierre Graux M.D.  Sylvestre Maréchaux M.D.   Ph.D.
Affiliation:1. Cardiology Department, Université Lille Nord de France/Groupement Hospitalier de l'Institut Catholique de Lille/Faculté Libre de Médecine, Université Catholique de Lille, , Lille, France;2. Cardiology Department, Armentières Hospital, , Armentières, France
Abstract:We report the case of a 73‐year‐old man admitted for refractory heart failure following implantation of a dual‐chamber pacemaker. Three‐dimensional (3D) echocardiography with speckle tracking area strain identified severe left ventricular (LV) dysfunction and LV dyssynchrony following right ventricular pacing. As the patient's clinical condition rapidly worsened despite optimal medical treatment, a cardiac resynchronization therapy (CRT) pacemaker was successfully implanted as rescue therapy. Symptoms rapidly regressed and echocardiographic assessment following CRT demonstrated an immediate improvement in LV systolic function, confirmed at 9‐month follow‐up with evidence of reverse remodeling. New imaging technologies such as 3D echocardiography with speckle tracking area strain may help to identify and follow up patients who will benefit from CRT as rescue therapy.
Keywords:heart failure  strain  three‐dimensional transthoracic echocardiography  left ventricular remodeling  cardiogenic shock  cardiac pacing
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