Dramatic Response to Cardiac Resynchronization Therapy With AV Delay Optimization in Narrow QRS XXXX .

@entity1 @entity384 @entity712 @entity9719
UNASSIGNED: Cardiac resynchronization therapy (CRT) has been shown to be effective for @entity712 . However, as outlined in the AHA/ACC/ @entity9719 Appropriate Use Criteria, CRT is not strongly recommended for @entity1 with a narrow QRS complex. We describe a case of @entity384 and narrow QRS complex in which we obtained a dramatic response to CRT by optimizing the atrioventricular (AV) delay. The @entity1 was a 61-year-old @entity1 with intractable @entity712 . Echocardiography showed a low ejection fraction of 22% but no dyssynchrony. Because he had been hospitalized many times for @entity712 despite b-blocker and diuretic treatment, we decided to use CRT. However, after implantation of the CRT device, the QRS complex widened abnormally, and his symptoms worsened. He was re-admitted 2 months after CRT implantation. We examined the pacemaker status and optimized the AV delay to obtain a "narrow" QRS complex. The @entity1 's condition improved dramatically after the AV delay optimization. His clinical status has been good, and there has been no subsequent hospitalization. Our case points to the effectiveness of CRT in @entity1 with a narrow QRS complex and to the importance of AV optimization for successful CRT.
