Figure 4.

Transthoracic echocardiography after upgrading to cardiac resynchronization therapy and a modified apical four-chamber view from the right hemithorax. The objective parameters persisted despite the therapy. Thickness of the systemic right ventricle free wall 13 mm, right ventricle ejection fraction 25%, left ventricle ejection fraction 50%, moderate regurgitation of the morphological tricuspid valve, and mild regurgitation of the morphological mitral valve. LA, left atrium; LV, subpulmonary left ventricle; RA, right atrium; RV, systemic right ventricle; solid arrow, left ventricle electrode.