Journal
HEART RHYTHM
Volume 19, Issue 4, Pages 658-666Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2021.11.032
Keywords
Cardiac resynchronization therapy; Congenital heart disease; Systemic right ventricle; Transposition of the great arteries; Heart failure
Categories
Funding
- Federation Francaise de Cardiologie
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This multicenter cohort study found that one-third of patients with CHD implanted with a CRT device had SRV. Patients with SRV showed similar rates of response to CRT compared to patients with systemic left ventricle.
BACKGROUND Although patients with systemic right ventricle (SRV) represent a significant proportion of patients with congenital heart disease (CHD) implanted with cardiac resynchronization therapy (CRT), there are limited and conflicting data in this specific patient group. OBJECTIVE We aimed to analyze outcomes of patients with SRV implanted with a CRT device. METHODS Data were analyzed from an observational, retrospective, multicenter cohort study including all patients with CHD implanted with a CRT device from 6 French centers from 2004 to 2020. Response to CRT was defined as an increase in systemic ventricular ejection fraction of >= 10% and/or an improvement in New York Heart Association functional class by at least 1 grade. RESULTS A total of 85 patients with CHD were enrolled (mean age 39.8 +/- 20.0 years; 55 [64.7%] males; 25 defibrillators [29.4%]), including 31 patients with SRV (36.5%) (mean age 43.9 +/- 19.8 years; 16 [51.6%] males). The mean change in QRS duration after implantation was similar as compared with patients with systemic left ventricle (-46 +/- 26 ms vs-35 +/- 32 ms; P = .16). During a mean follow-up of 5.1 +/- 3.5 years, late complications included 2 lead dysfunctions (6.5%), 3 CRT-related infections (9.7%), and 1 inappropriate implantable cardioverter-defibrillator shock (3.2%). The proportion of CRT responders at 6, 12, and 24 months were 82.6%, 80.0%, and 77.8% in patients with SRV vs 66.7%, 64.3%, and 69.6% in patients with systemic left ventricle (P = NS). CONCLUSION In this multicenter cohort, one-third of patients with CHD implanted with a CRT device had SRV. CRT in patients with SRV was associated with a high rate of responders, comparable to that of patients with systemic left ventricle.
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