Vanita Arora1, Francesco Zanon2, Viveka Kumar3, Vivek Kumar3, Pawan Suri4. 1. Max Healthcare Superspeciality Hospital, Saket, New Delhi, India. aroraheartrhythmdoc@yahoo.com. 2. Santa Maria della Misericordia Hospital, Rovigo, Italy. 3. Max Healthcare Superspeciality Hospital, Saket, New Delhi, India. 4. SGL Multispeciality Hospital, Jalandhar, Punjab, India.
Abstract
BACKGROUND: As per the literature, patients with intraventricular conduction delay (IVCD) do not respond well to cardiac resynchronization therapy (CRT) alone. They need advanced technological approach and out of the box thinking for a good response. CASE: Ours is a case of ischemic cardiomyopathy with wide QRS-IVCD, a non-responder to CRT. While planning for replacement of the device for early replacement indicator (ERI), we decided to do His-optimized CRT/left bundle optimized CRT (HOT-CRT/LOT-CRT) for the patient. CONCLUSION: The challenges we faced with the present available hardware paved a way for insisting on the limitation of the available lumenless lead to penetrate calcified the septum and importance of the pre-procedure evaluation of intraventricular septum (IVS) for calcification by more than just echocardiography.
BACKGROUND: As per the literature, patients with intraventricular conduction delay (IVCD) do not respond well to cardiac resynchronization therapy (CRT) alone. They need advanced technological approach and out of the box thinking for a good response. CASE: Ours is a case of ischemic cardiomyopathy with wide QRS-IVCD, a non-responder to CRT. While planning for replacement of the device for early replacement indicator (ERI), we decided to do His-optimized CRT/left bundle optimized CRT (HOT-CRT/LOT-CRT) for the patient. CONCLUSION: The challenges we faced with the present available hardware paved a way for insisting on the limitation of the available lumenless lead to penetrate calcified the septum and importance of the pre-procedure evaluation of intraventricular septum (IVS) for calcification by more than just echocardiography.
Entities:
Keywords:
Case report; HOTCRT; His bundle pacing; Physiological pacing
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