Congenital heart diseaseCohort study
How to assess and treat right ventricular electromechanical dyssynchrony in post-repair tetralogy of Fallot: insights from imaging, invasive studies, and computational modelling
- Case series with computational modelling
Authors' conclusion
An integrative diagnostic approach to RV dysfunction, including the construction of Digital Twins may help to identify candidates for RV-CRT as part of the lifetime management of ToF and similar congenital heart lesions.
Study context
- Population
- Patients with repaired tetralogy of Fallot (ToF), complete right bundle branch block (RBBB), pulmonary regurgitation and significantly decreased right ventricular (RV) function
- Participants
- 2 patients
Main finding
As reported in the abstract
RV dyssynchrony and RV systolic function with RV-CRT
- Classic RV dyssynchrony pattern on echocardiography reversed by RV cardiac resynchronization therapy (RV-CRT) during invasive study, with acute improvement in RV systolic function
- Digital Twins confirmed a contribution of electromechanical RV dyssynchrony to RV dysfunction and suggested improved RV contraction efficiency after RV-CRT
- The one patient with successful permanent RV-CRT (with pulmonary re-valvulation) improved in line with his Digital Twin's predictions
Observational data: associations, not effects.
Original publication
How to assess and treat right ventricular electromechanical dyssynchrony in post-repair tetralogy of Fallot: insights from imaging, invasive studies, and computational modelling. Europace. Published 24 January 2024. doi:10.1093/europace/euae024
Summarised from the published abstract; every number is checked against it