Acute cardiac resynchronization therapy for right ventricular disease

Right ventricular disease has increasing clinical relevance, because it affects
a growing number of patients. Yet, effective therapies are lacking. We have
recently established that the clinical severity of right ventricular disease is
largely determined by electrical interventricular dyssynchrony, i.e., delay of
electrical activity between the right and left ventricles. In this study, we
aim to establish whether acute correction of this dyssynchrony by temporary
electrical pacing attenuates the clinical severity of right ventricular disease

To attenuate the clinical severity of right ventricular disease by electrical
pacing

Acute intervention study

acute cardiac resynchronization therapy (CRT), i.e., temporary right atrial and
right ventricular pacing immediately after routine right heart catheterization

Acute CRT will take 30-45 min (including the associated assays such as tissue
Doppler echocardiography, FinaPress*, and SDF) and will be conducted
immediately after routine right heart catheterization and coronary angiography
in the catheterization room. Thus, the subject will undergo an additional 30-45
min of study. Based on our extensive experience with temporary cardiac pacing
in the catheterization room, we do not expect adverse events form this study.
We do not aim for immediate benefit for the subject, because this study entails
temporary CRT. However, these studies can only be conducted in this patient
group (CTEPH) patients, because we have established the pathophysiological
basis and rationale of this study in this patient group. It must be noted that
chronic CRT may be considered in these patients if the present study should
prove successful. Chronic CRT may benefit CTEPH patients, in particular, those
who are ineligible for pulmonary endarterectomy or in whom pulmonary
endarterectomy has not resulted in improved functional class.