Pacing treatment for dilated cardiomyopathy: optimization of resynchronization pacing in pediatrics

Purpose of review The understanding of the therapeutic effects and complications of pacing in pediatric and congenital-heart disease is evolving. The utility and feasibility of cardiac resynchronization therapy (CRT) are now being critically evaluated. This group of patients is heterogeneous, but many individuals eventually share a common clinical destiny of ventricular dyssynchrony and dilated cardiomyopathy. This review will summarize the most recent germane developments in this rapidly changing field. Recent findings Longer-term data are now available for the pediatric and congenital heart population. Some of the technical aspects of this procedure have been improved, including the use of unique combinations of lead placement including hybrid systems. Innovations in echocardiography provide the clinician with the capability to assess mechanical dyssynchrony indices, as well as cardiac function and electrical dyssynchrony, when considering a pediatric or congenital heart disease patient for CRT. Summary CRT is becoming a valuable tool in the treatment of ventricular dyssynchrony and dilated cardiomyopathy in pediatric and congenital heart disease patients. Diagnostic advances in electrophysiology and echocardiography have enabled clinicians to more effectively evaluate, treat, and optimize device programming for patients before and after CRT. These modalities also allow more detailed data collection, which may aid in the refinement of indications and impact of CRT in this unique population.