VDD-ICD Implantation in a Patient with Dextrocardia and Corrected Transposition of the Great Arteries
We present the case of a 52-year-old female patient on optimal medical therapy (OMT) for heart failure with severely reduced ejection fraction. She was diagnosed with dextrocardia and congenital corrected transposition of the great arteries (ccTGA) by echocardiography. Despite 3 months of OMT and a...
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Promenade Kft
2024-10-01
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| Series: | Cardiologia Hungarica |
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| Online Access: | https://cardiologia.hungarica.eu/archive/2024-issues/2024-5-contents/vdd-icd-implantation-in-a-patient-with-dextrocardia-and-corrected-transposition-of-the-great-arteries?article=open |
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| author | Krisztián István Kássa Zoltán Som Attila Kardos Csaba Földesi |
| author_facet | Krisztián István Kássa Zoltán Som Attila Kardos Csaba Földesi |
| author_sort | Krisztián István Kássa |
| collection | DOAJ |
| description | We present the case of a 52-year-old female patient on optimal medical therapy (OMT) for heart failure with severely reduced ejection fraction. She was diagnosed with dextrocardia and congenital corrected transposition of the great arteries (ccTGA) by echocardiography. Despite 3 months of OMT and a persisting NYHA II functional state, she was referred for primary prevention ICD implantation.
At admission echocardiography revealed a hypertrophic systemic ventricle with an ejection fraction of 27%. Cardiac CT confirmed ccTGA, dextrocardia, a normal extracardiac and epicardial venous system. Coronary artery disease was excluded.
Our team opted for left-sided VDD-ICD implantation in case of a need for AV-synchronous pacing and to enhance arrhythmia discrimination. An active fixation shock lead was placed in the mid-septal region of the functional right ventricle. The defibrillation threshold test (DFT) was successful at 20 J.
No periprocedural complications were observed. At the 12-month ambulatory visit, device interrogation showed good function, no detected arrhythmias, and no antitachycardia therapy was delivered.
Preoperative imaging is essential prior to any invasive cardiac procedure in patients with congenital heart disease. Performing a DFT test at adult congenital heart disease patients may be reasonable. |
| format | Article |
| id | doaj-art-5eeccccd02184819bc06a0b1a5dcea3e |
| institution | Kabale University |
| issn | 0133-5596 1588-0230 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Promenade Kft |
| record_format | Article |
| series | Cardiologia Hungarica |
| spelling | doaj-art-5eeccccd02184819bc06a0b1a5dcea3e2024-11-12T09:09:44ZengPromenade KftCardiologia Hungarica0133-55961588-02302024-10-0154537838010.26430/CHUNGARICA.2024.54.5.378VDD-ICD Implantation in a Patient with Dextrocardia and Corrected Transposition of the Great ArteriesKrisztián István Kássa0Zoltán Som1Attila Kardos2Csaba Földesi3Gottsegen György Országos Kardiovaszkuláris Intézet, BudapestGottsegen György Országos Kardiovaszkuláris Intézet, BudapestGottsegen György Országos Kardiovaszkuláris Intézet, BudapestGottsegen György Országos Kardiovaszkuláris Intézet, BudapestWe present the case of a 52-year-old female patient on optimal medical therapy (OMT) for heart failure with severely reduced ejection fraction. She was diagnosed with dextrocardia and congenital corrected transposition of the great arteries (ccTGA) by echocardiography. Despite 3 months of OMT and a persisting NYHA II functional state, she was referred for primary prevention ICD implantation. At admission echocardiography revealed a hypertrophic systemic ventricle with an ejection fraction of 27%. Cardiac CT confirmed ccTGA, dextrocardia, a normal extracardiac and epicardial venous system. Coronary artery disease was excluded. Our team opted for left-sided VDD-ICD implantation in case of a need for AV-synchronous pacing and to enhance arrhythmia discrimination. An active fixation shock lead was placed in the mid-septal region of the functional right ventricle. The defibrillation threshold test (DFT) was successful at 20 J. No periprocedural complications were observed. At the 12-month ambulatory visit, device interrogation showed good function, no detected arrhythmias, and no antitachycardia therapy was delivered. Preoperative imaging is essential prior to any invasive cardiac procedure in patients with congenital heart disease. Performing a DFT test at adult congenital heart disease patients may be reasonable.https://cardiologia.hungarica.eu/archive/2024-issues/2024-5-contents/vdd-icd-implantation-in-a-patient-with-dextrocardia-and-corrected-transposition-of-the-great-arteries?article=openvdd-icdhfrefdextrocardiacctgadft test |
| spellingShingle | Krisztián István Kássa Zoltán Som Attila Kardos Csaba Földesi VDD-ICD Implantation in a Patient with Dextrocardia and Corrected Transposition of the Great Arteries Cardiologia Hungarica vdd-icd hfref dextrocardia cctga dft test |
| title | VDD-ICD Implantation in a Patient with Dextrocardia and Corrected Transposition of the Great Arteries |
| title_full | VDD-ICD Implantation in a Patient with Dextrocardia and Corrected Transposition of the Great Arteries |
| title_fullStr | VDD-ICD Implantation in a Patient with Dextrocardia and Corrected Transposition of the Great Arteries |
| title_full_unstemmed | VDD-ICD Implantation in a Patient with Dextrocardia and Corrected Transposition of the Great Arteries |
| title_short | VDD-ICD Implantation in a Patient with Dextrocardia and Corrected Transposition of the Great Arteries |
| title_sort | vdd icd implantation in a patient with dextrocardia and corrected transposition of the great arteries |
| topic | vdd-icd hfref dextrocardia cctga dft test |
| url | https://cardiologia.hungarica.eu/archive/2024-issues/2024-5-contents/vdd-icd-implantation-in-a-patient-with-dextrocardia-and-corrected-transposition-of-the-great-arteries?article=open |
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