Classic-Pattern Dyssynchrony in Adolescents and Adults With a Fontan Circulation

Ventricular mechanics in adolescent and adult patients with a Fontan circulation: Relation to geometry and wall stress

“…In accordance with our study, several previous studies reported heterogeneity of regional function, especially in dominant right ventricular anatomy . As shown in a previous publication on the same patient cohort, only 15% of UVH showed signs of electromechanical dyssynchrony, displaying a typical pattern of pre‐stretch and contraction of opposing walls . However, in the majority of functionally single ventricles, regional strain was reduced at normal QRS width and without classic pattern dyssynchrony present.…”

“…85/1212 segments (7.5%) were excluded from analysis in the patient cohort. Table shows the baseline characteristics of the study population . At the time of echocardiography, average age was 21 ± 10 years, 60% were male, and all patients were in sinus rhythm.…”

“…However, in contrary to the studies’ hypothesis we could not show significant impact of regional curvatures and wall thickness on regional deformation. Even though regional as well as global deformation parameters are load dependent and thus dependent on regional geometry, other factors like interventricular dependence, fiber orientation, conduction delays, fibrous tissue, or pericardial adhesions have obviously higher impact on the degree of regional reduced deformation.…”

Successful biventricular cardiac resynchronization therapy in a failing Fontan patient: Implications of ventriculo‐ventricular interdependency in single ventricle physiology

“…The presence of ventricular dyssynchrony in patients with single ventricle (SV) physiology has led to an increased interest in the application of cardiac resynchronization therapy (CRT) in subjects with evident heart failure. [1][2][3][4] However, conflicting results of CRT response has been reported, suggesting that only a subgroup of SV patients have an electrical substrate amenable to CRT. [1][2][3][4] Strain imaging has been very helpful to identify CRT-responsive dyssynchrony patterns in adults with left ventricular dysfunction that are related to an electromechanical substrate.…”

“…1-4 However, conflicting results of CRT response has been reported, suggesting that only a subgroup of SV patients have an electrical substrate amenable to CRT. [1][2][3][4] Strain imaging has been very helpful to identify CRT-responsive dyssynchrony patterns in adults with left ventricular dysfunction that are related to an electromechanical substrate. 5 The adjunctive role of strain imaging in selecting SV patients suitable for CRT is not well established.In this report, we describe a Fontan patient with severe heart failure who was successfully treated with biventricular CRT.…”