Cardiac resynchronization therapy in patients with congenital heart disease and systemic right ventricle

Etienne Jacquemart1, Nicolas Combes2, Guillaume Duthoit3

  • 1Université de Paris, PARCC, INSERM, Paris, France.

Heart Rhythm
|December 5, 2021
PubMed

Insights

Cardiac resynchronization therapy (CRT) is effective in patients with congenital heart disease (CHD) and a systemic right ventricle (SRV). Outcomes in SRV patients were comparable to those with a systemic left ventricle, showing high CRT response rates.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Electrophysiology

Background:

  • Systemic right ventricle (SRV) patients form a significant subgroup of congenital heart disease (CHD) patients receiving cardiac resynchronization therapy (CRT).
  • Existing data on CRT outcomes in SRV patients are limited and often conflicting.

Purpose of the Study:

  • To analyze the outcomes of cardiac resynchronization therapy (CRT) in patients with a systemic right ventricle (SRV).
  • To compare CRT response rates in SRV patients versus those with a systemic left ventricle.

Main Methods:

  • Retrospective, multicenter cohort study (2004-2020) involving 85 patients with CHD who received CRT.
  • Defined CRT response as ≥10% increase in systemic ventricular ejection fraction and/or ≥1 grade improvement in NYHA functional class.
  • Included 31 patients with SRV and compared their outcomes to patients with a systemic left ventricle.

Main Results:

  • A total of 85 CHD patients were included, with 31 (36.5%) having SRV.
  • CRT response rates at 6, 12, and 24 months were high in SRV patients (82.6%, 80.0%, 77.8%) and comparable to systemic left ventricle patients (66.7%, 64.3%, 69.6%).
  • Late complications were infrequent, including lead dysfunction, CRT-related infections, and inappropriate ICD shocks.

Conclusions:

  • Approximately one-third of CHD patients receiving CRT in this cohort had an SRV.
  • Cardiac resynchronization therapy (CRT) demonstrates a high response rate in patients with systemic right ventricle (SRV), similar to those with a systemic left ventricle.
  • CRT is a viable and effective treatment option for selected CHD patients with SRV.
Abstract

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