Cardiac resynchronization therapy for adult congenital heart disease patients with a systemic right ventricle: analysis of feasibility and review of early experience.
OBJECTIVE
Patients with a systemic right ventricle (RV) frequently develop heart failure and may benefit from cardiac resynchronization therapy (CRT). We aimed to assess the proportion of unselected patients with a systemic RV eligible for CRT and to review available data on the effect of CRT in congenital heart disease patients.


RESULTS
Adhering to criteria derived from landmark CRT trials, we determined the eligibility of patients with a systemic RV for CRT. Seventy-five transposition of the great arteries (TGA) patients (age 29.5+/-10.2 years) and 49 patients with congenitally corrected (cc) TGA (age 36.2+/-12.8 years) were studied. Full criteria for CRT were met in 4.0% of the TGA patients and 4.1% of the ccTGA patients. Including New York Heart Association class 2 patients, 9.3% of TGA and 6.1% of ccTGA patients were eligible for CRT.


CONCLUSIONS
Four to 9% of unselected patients with a systemic RV appear to be potential candidates for CRT. Although large clinical studies are currently lacking, available data consistently demonstrate that CRT improves haemodynamics in congenital heart disease patients and warrants further investigation.
Diller
Gerhard-Paul
GP
Adult Congenital Heart Programme, Royal Brompton Hospital, Sydney Street, SW3 6NP London, UK. g.diller@imperial.ac.uk
Okonko
Darlington
D
Uebing
Anselm
A
Ho
Siew Yen
SY
Gatzoulis
Michael A
MA
D000328:Adult; D002304:Cardiac Pacing, Artificial; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014188:Transposition of Great Vessels / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy*; D018497:Ventricular Dysfunction, Right / Q000151:congenital / Q000503:physiopathology* / Q000628:therapy*