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Updated: Aug 14, 2026
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Resynchronization therapy in pediatric and congenital heart disease patients: an international multicenter study
Anne M Dubin1, Jan Janousek, Edward Rhee
1Lucile Packard Children's Hospital, Palo Alto, California, USA. amdubin@stanford.edu
Insights
Cardiac resynchronization therapy (CRT) shows short-term benefits in pediatric patients with heart conditions. This study evaluated CRT
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Congenital Heart Disease
Background:
- Cardiac resynchronization therapy (CRT) is effective in adults with heart failure and conduction delays.
- Efficacy of CRT in pediatric populations, especially those with congenital heart disease (CHD), is not well-established.
Purpose of the Study:
- To assess the short-term safety and effectiveness of cardiac resynchronization therapy (CRT) in children.
- To investigate CRT outcomes in pediatric patients with various cardiac conditions, including CHD.
Main Methods:
- A multi-center, retrospective study involving 103 pediatric patients.
- Data collected from 22 institutions on patient demographics, diagnoses, and CRT outcomes.
Main Results:
- CRT significantly reduced QRS duration (166.1 to 128.4 ms) and improved ejection fraction (26.2% to 39.9%).
- Positive outcomes were observed in patients with CHD, cardiomyopathy, and congenital complete atrioventricular block.
- Among 18 patients awaiting heart transplant, 3 improved enough to be removed from the list.
Conclusions:
- Cardiac resynchronization therapy (CRT) appears beneficial for pediatric patients, including those with CHD.
- Further research is necessary to determine the long-term efficacy of CRT in this population.
Objectives:
Our objective was to evaluate the short-term safety and efficacy of cardiac resynchronization therapy (CRT) in children.
Background:
Cardiac resynchronization therapy has been beneficial for adult patients with poor left ventricular function and intraventricular conduction delay. The efficacy of this therapy in the young and in those with congenital heart disease (CHD) has not yet been established.
Methods:
This is a multi-center, retrospective evaluation of CRT in 103 patients from 22 institutions.
Results:
Median age at time of implantation was 12.8 years (3 months to 55.4 years). Median duration of follow-up was four months (22 days to 1 year). The diagnosis was CHD in 73 patients (71%), cardiomyopathy in 16 (16%), and congenital complete atrioventricular block in 14 (13%). The QRS duration before pacing was 166.1 +/- 33.3 ms, which decreased after CRT by 37.7 +/- 30.7 ms (p < 0.01). Pre-CRT systemic ventricular ejection fraction (EF) was 26.2 +/- 11.6%. The EF increased by 12.8 +/- 12.7 EF units with a mean EF after CRT of 39.9 +/- 14.8% (p < 0.05). Of 18 patients who underwent CRT while listed for heart transplantation, 3 improved sufficiently to allow removal from the transplant waiting list, 5 underwent transplant, 2 died, and 8 others are currently awaiting transplant.
Conclusions:
Cardiac resynchronization therapy appears to offer benefit in pediatric and CHD patients who differ substantially from the adult populations in whom this therapy has been most thoroughly evaluated to date. Further studies looking at the long-term benefit of this therapy in this population are needed.
