Cardiac resynchronization therapy in patients with congenital heart disease and systemic right ventricle
Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
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| Enthalten in: |
Heart rhythm - 19(2022), 4 vom: 15. Apr., Seite 658-666 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jacquemart, Etienne [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 05.04.2022 Date Revised 21.05.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.hrthm.2021.11.032 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 245 | 1 | 0 | |a Cardiac resynchronization therapy in patients with congenital heart disease and systemic right ventricle |
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| 500 | |a Date Revised 21.05.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a 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 | ||
| 520 | |a OBJECTIVE: We aimed to analyze outcomes of patients with SRV implanted with a CRT device | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Cardiac resynchronization therapy | |
| 650 | 4 | |a Congenital heart disease | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Systemic right ventricle | |
| 650 | 4 | |a Transposition of the great arteries | |
| 700 | 1 | |a Combes, Nicolas |e verfasserin |4 aut | |
| 700 | 1 | |a Duthoit, Guillaume |e verfasserin |4 aut | |
| 700 | 1 | |a Bessière, Francis |e verfasserin |4 aut | |
| 700 | 1 | |a Ladouceur, Magalie |e verfasserin |4 aut | |
| 700 | 1 | |a Iserin, Laurence |e verfasserin |4 aut | |
| 700 | 1 | |a Laredo, Mikael |e verfasserin |4 aut | |
| 700 | 1 | |a Bredy, Charlène |e verfasserin |4 aut | |
| 700 | 1 | |a Maltret, Alice |e verfasserin |4 aut | |
| 700 | 1 | |a Di Filippo, Sylvie |e verfasserin |4 aut | |
| 700 | 1 | |a Hascoët, Sébastien |e verfasserin |4 aut | |
| 700 | 1 | |a Pasquié, Jean-Luc |e verfasserin |4 aut | |
| 700 | 1 | |a Marijon, Eloi |e verfasserin |4 aut | |
| 700 | 1 | |a Waldmann, Victor |e verfasserin |4 aut | |
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