Classic-Pattern Dyssynchrony and Electrical Activation Delays in Pediatric Dilated Cardiomyopathy

Distribution of strain patterns in children with dilated cardiomyopathy

“…Our results are in line with the results of Forsha et al 13 CRT has no favorable effect on outcome and may even be harmful. 20 Therefore, the role of CRT in children with DCM may be limited.…”

“…[3][4][5] In addition, global peak strain has been associated with the risk of death and heart transplantation in both children and adults with DCM. 13 In a previous study, we concluded that global peak strain is predictive for heart transplantation or death in a large nationwide cohort of DCM patients. The presence of dyssynchrony in adults is related to adverse outcome and has been used to predict the effectiveness of cardiac resynchronization therapy (CRT).…”

Cardiac resynchronization therapy: Identifying an activation delay by regional strain analysis

“…Initial results are highly encouraging [22] and emphasizes that evaluation of the ECG cannot always stand alone.…”

Applying Cardiac Resynchronization Criteria to Pediatric Patients: Fitting a Square Peg into a Round Hole?

“…20 In Forsha's adaptation of classic-pattern dyssynchrony in children having dilated cardiomyopathy and severe disease, QRS duration was >98th percentile for age in 6 of 7 patients having classic-pattern dyssynchrony, but only 2 of those patients had classical LBBB morphology. 21 Since 20 of 52 (38%) patients in Schiller's current cohort had a prolonged QRS duration (with none having LBBB), we wonder how many of those 20 would have had classic-pattern dyssynchrony. Classic-pattern dyssynchrony responds to CRT with reverse remodeling in over 90% of adult patients.…”

“…For example, in classic‐pattern dyssynchrony (a robust method for identifying homogeneous delayed left ventricular activation), Risum's cohort of responders had a QRS duration of 159 ± 18 milliseconds, compared with nonresponders, whose QRS duration was still 146 ± 13 milliseconds . In Forsha's adaptation of classic‐pattern dyssynchrony in children having dilated cardiomyopathy and severe disease, QRS duration was >98th percentile for age in 6 of 7 patients having classic‐pattern dyssynchrony, but only 2 of those patients had classical LBBB morphology . Since 20 of 52 (38%) patients in Schiller's current cohort had a prolonged QRS duration (with none having LBBB), we wonder how many of those 20 would have had classic‐pattern dyssynchrony.…”