Cardiac resynchronization therapy was employed in this case outside of current guidelines as salvage therapy for a patient who was ventilator dependent. Although cases like this are rare, CRT should be considered for suitable patients who cannot be weaned from mechanical ventilation because of severe LV dysfunction with broad QRS complexes.
References1 Leclercq C, Cazeau S, Le Breton L, Ritter P, Mabo P, Gras D et al. Acute hemodynamic effects of biventricular DDD pacing in patients with end-stage heart failure. J Am Coll Cardiol 1998; 32: 1825-31. 2 Kass D, Chen C, Curry C, Talbot M, Berger R, Fetics M et al. Improved Left ventricular mechanics from acute VDD pacing in patients with dilated cardiomyopathy and ventricular conduction delay. Circulation 1999; 99: 1567-73. 3 Nelson G, Berger R, Fetics B, Talbot M, Spinelli J, Hare J et al. Left ventricular or biventricular pacing improves cardiac function at diminished energy cost in patients with dilated cardiomyopathy and left bundle-branch block. Circulation 2000; 102: 3053-9. 4 Breithardt O, Sinha A, Schwammenthal E, Bidaoui N, Markus K, Franke A et al. Acute effects of cardiac resynchronization therapy on functional mitral regurgitation in advanced systolic heart failure. J Am Coll Cardiol 2003; 41: 765-70. 5 Milliez P, Thomas O, Haggui A, Schurando P, Squara P et al. Cardiac resynchronisation as a rescue therapy in patients with catecholamine-dependent overt heart failure: results from a short and mid-term study. Eur J Heart Fail 2008; 10: 291-7. 6 Cleland J, Daubert J, Erdmann E, Freemantle N, Gras D, Kappenberger L et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 2005; 352: 1539-49.