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An analysis of defibrillation and cardiac resynchronization therapy strategies in patients with failing systemic right ventricles
Includes bibliographical references (leaves 52-56).
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| Main Author: | |
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Division of Cardiology
2014
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| _version_ | 1867613184781713408 |
|---|---|
| access_status_str | Open Access |
| author | Michael, Kevin A |
| author2 | Morgan, John M |
| author_browse | Michael, Kevin A Morgan, John M |
| author_facet | Morgan, John M Michael, Kevin A |
| author_sort | Michael, Kevin A |
| collection | Thesis |
| description | Includes bibliographical references (leaves 52-56). |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/2827 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:07.214Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2014 |
| publishDateRange | 2014 |
| publishDateSort | 2014 |
| publisher | Division of Cardiology |
| publisherStr | Division of Cardiology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/2827 An analysis of defibrillation and cardiac resynchronization therapy strategies in patients with failing systemic right ventricles Michael, Kevin A Morgan, John M Cardiology Includes bibliographical references (leaves 52-56). The expanding application of cardiac resynchronization (CRT) and implantable cardioverter-defibrillator therapy (lCD) to include patients with congenital heart disease requires careful evaluation of selection criteria and unconventional adaptive strategies to ensure clinical efficacy. A single centre prospective analysis of adults post atrial redirection surgery (Mustard operation) for dextro-transposition of the great arteries (d-TGA) presenting with systemic right ventricular (sRV) dysfunction and at risk of sudden cardiac death (SCD). All patients ( mean age 25 years, range 18-35) with varying functional disability{New York Heart Association (NYHA) II-III} receiving ICDs ± concomitant CRT were evaluated. Total follow-up period was 24 months. A patient individualized approach was used for device implantation. Endocardial, epicardial and transthoracic defibrillation strategies were examined in 5 consecutive cases. A hybridized form of CRT was employed in two patients. Only one patient demonstrated response to therapy while the other deteriorated during biventricular pacing (BVP). This prompted a novel approach to CRT using noncontact mapping (NCM) and acute intra-arterial blood pressure response to guide endocardialsRV lead placement in a single patient. The ejection fraction increased from 23 -33% within 1week post procedure and clinical improvement was sustained after 6-months follow-up. Application of CRT II CD therapy to patients with sRV dysfunction requires individualized and adaptive strategies to overcome anatomical constraints. This study represents a chronological and evolutionary account of these measures. 2014-07-28T13:32:19Z 2014-07-28T13:32:19Z 2007 Master Thesis Masters MPhil http://hdl.handle.net/11427/2827 eng application/pdf Division of Cardiology Faculty of Health Sciences University of Cape Town |
| spellingShingle | Cardiology Michael, Kevin A An analysis of defibrillation and cardiac resynchronization therapy strategies in patients with failing systemic right ventricles |
| thesis_degree_str | Master's |
| title | An analysis of defibrillation and cardiac resynchronization therapy strategies in patients with failing systemic right ventricles |
| title_full | An analysis of defibrillation and cardiac resynchronization therapy strategies in patients with failing systemic right ventricles |
| title_fullStr | An analysis of defibrillation and cardiac resynchronization therapy strategies in patients with failing systemic right ventricles |
| title_full_unstemmed | An analysis of defibrillation and cardiac resynchronization therapy strategies in patients with failing systemic right ventricles |
| title_short | An analysis of defibrillation and cardiac resynchronization therapy strategies in patients with failing systemic right ventricles |
| title_sort | analysis of defibrillation and cardiac resynchronization therapy strategies in patients with failing systemic right ventricles |
| topic | Cardiology |
| url | http://hdl.handle.net/11427/2827 |
| work_keys_str_mv | AT michaelkevina ananalysisofdefibrillationandcardiacresynchronizationtherapystrategiesinpatientswithfailingsystemicrightventricles AT michaelkevina analysisofdefibrillationandcardiacresynchronizationtherapystrategiesinpatientswithfailingsystemicrightventricles |