Cardiac Resynchronization Therapy for Various Systemic Ventricular Morphologies in Patients With Congenital Heart Disease

Sakaguchi, Heima; Miyazaki, Aya; Yamada, Osamu; Kagisaki, Koji; Hoashi, Takaya; Ichikawa, Hajime; Ohuchi, Hideo

doi:10.1253/circj.cj-14-0395

Cited by 34 publications

(8 citation statements)

References 26 publications

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“…In a study of 20 patients, Sakaguchi et al showed that in a mixed population of children and adult patients with a systemic LV or single ventricular physiology, CRT led to a reduction in ventricular volume. 9 In a retrospective study comprising children with CHD (n = 73) or cardiomyopathy (n = 16) (median age 12.8 years; follow-up of 4 months), the SVEF improved after CRT. 4 In a was associated with an increase in SVEF from 36% to 42% (P < .001) and an improvement in functional status was observed in 87% of patients with follow-up data.…”

Section: Discussionmentioning

confidence: 99%

“…Although CRT is being undertaken in the pediatric and adult population with sACHD, studies in its favor have only focused on surrogate predictors of outcome. In a study of 20 patients, Sakaguchi et al showed that in a mixed population of children and adult patients with a systemic LV or single ventricular physiology, CRT led to a reduction in ventricular volume . In a retrospective study comprising children with CHD (n = 73) or cardiomyopathy (n = 16) (median age 12.8 years; follow‐up of 4 months), the SVEF improved after CRT .…”

Section: Discussionmentioning

confidence: 99%

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Long‐term outcomes of cardiac resynchronization therapy in adult congenital heart disease

Leyva

Zegard

Qiu

et al. 2019

Pacing Clinical Electrophis

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Background and AimsRandomized, controlled trials of cardiac resynchronization therapy (CRT) excluded patients with adult congenital heart disease (ACHD). We sought to explore long‐term clinical outcomes.Methods and ResultsIn this single‐center, observational study, events were collected from hospital records on patients with structural ACHD (sACHD) and adults with ischemic (ICM) or nonischemic (NICM) cardiomyopathy undergoing CRT. Patients with sACHD (n = 23, age: 41.6 ± 13.5 years [mean ± standard deviation]) and adults with ICM (n = 533) or NICM (n = 458) were followed‐up for 4.1 years (median; interquartile range: 2.2‐6.1). Total mortality was 5/23 (21.7%; 4.4 per 100 person‐years) in sACHD, 221/533 (41.5%; 11.8 per 100 person‐years) in ICM, and 154/458 (33.6%; 9.7 per 100 person‐years) in NICM. In univariate analyses, total mortality in sACHD was lower than in ICM (hazard ratio [HR]: 0.38; 95% confidence interval [CI] 0.15‐0.91), but similar to NICM (HR: 0.48, 95% CI 0.20‐1.16). Cardiac mortality in sACHD was similar to ICM (HR: 0.78, 95% CI 0.32‐1.92) and NICM (HR: 1.12, 95% CI 0.45‐2.78). Heart failure (HF) hospitalization rates were similar to ICM (HR: 0.44, 95% CI 0.11‐1.77) and NICM (HR: 0.75, 95% CI 0.18‐3.08). In multivariate analyses, no differences emerged in total mortality, cardiac mortality, or HF hospitalization between sACHD and NICM or ICM, after adjustment for age, sex, New York Heart Association class, diabetes, atrial rhythm, QRS duration, QRS morphology, systemic ventricular ejection fraction, and medical therapy.ConclusionTotal mortality, cardiac mortality, and HF hospitalization after CRT in patients with sACHD was similar to adults with ICM or NICM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long‐term outcomes of cardiac resynchronization therapy in adult congenital heart disease

Leyva

Zegard

Qiu

et al. 2019

Pacing Clinical Electrophis

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“…CRT in patients with a systemic RV is less effective than in those with a systemic LV or single ventricular physiology [10]. This could be attributed to the following qualities of a systemic RV: the lack of established optimal pacing sites, heterogeneous and complicated ventricular shapes, impaired myocardial perfusion, and the existence of myocardial fibrosis [14,15].…”

Section: Discussionmentioning

confidence: 99%

“…A three dimensional electroanatomical mapping system (NavX; St Jude Medical) was used. AoV aortic valve, PA pulmonary artery, TA tricuspid annulus ▸ endocardial electrode catheter on the RV free wall [10]. The pacing site in the RV was selected as the inferior site of the RV free wall, which resulted in the narrowest QRS duration (146 ms).…”

Section: Case Reportmentioning

confidence: 99%

Interventricular dyssynchrony in a patient with a biventricular physiology and a systemic right ventricle

et al. 2016

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We describe of a unique pattern of cardiac dyssynchrony in a patient with a biventricular physiology and systemic right ventricle (RV): the interventricular dyssynchrony due to a contraction delay between the left ventricle and RV. In the present case, the cineangiography and intracardiac electrocardiography of the RV did not reveal intraventricular dyssynchrony of the RV, but revealed interventricular dyssynchrony. In addition, the pressure curves of the ventricles exhibited time phase differences between the two ventricles. The cardiac resynchronization therapy determining the pacing lead positions based on the idea of interventricular dyssynchrony induced reverse cardiac remodeling in this patient with systemic RV dysfunction.

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“…Cardiac re-synchronisation therapy has had a strong impact on the treatment of many patients with heart failure and an abnormal QRS duration 1 . Furthermore, in patients with congenital heart disease, the effectiveness of cardiac re-synchronisation therapy pacing for electrical dyssynchrony has already been reported 2 . In this study, we report the simultaneous use of cardiac re-synchronisation therapy and total cavopulmonary connection in a patient with dyssynchrony, wide QRS, and cardiac failure.…”

mentioning

confidence: 83%

Simultaneous total cavopulmonary connection and cardiac re-synchronisation therapy

2017

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We report the simultaneous use of cardiac re-synchronisation therapy and total cavopulmonary connection in a patient with dyssynchrony, wide QRS, and cardiac failure. To our knowledge, this simultaneous approach has not been reported previously. On follow-up, we noted that QRS width and brain natriuretic peptide levels improved. In addition, speckle tracking revealed improved synchronisation of ventricular wall motion.

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Cardiac Resynchronization Therapy for Various Systemic Ventricular Morphologies in Patients With Congenital Heart Disease

Cited by 34 publications

References 26 publications

Long‐term outcomes of cardiac resynchronization therapy in adult congenital heart disease

Long‐term outcomes of cardiac resynchronization therapy in adult congenital heart disease

Interventricular dyssynchrony in a patient with a biventricular physiology and a systemic right ventricle

Simultaneous total cavopulmonary connection and cardiac re-synchronisation therapy

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