Cardiac resynchronisation therapy among adults with a systemic right ventricle: a multicentre experience.
Publication Title
Heart (British Cardiac Society)
Document Type
Article
Publication Date
11-5-2025
Keywords
ACHD; CRT; resynchronization therapy; systemic right ventricle.; washington; renton
Abstract
BACKGROUND: Cardiac resynchronisation therapy (CRT) is a key treatment for heart failure (HF) in acquired heart disease, but its benefits in adults with congenital heart disease and a systemic right ventricle (sRV) remain unclear. This study aimed to assess whether CRT improves outcomes in patients with sRV.
METHODS: This is an international, retrospective study including patients >18 years from 33 centres with transposition of the great arteries (TGA) following atrial switch operation and congenitally corrected TGA. The primary endpoint included overall survival and survival free from HF. The secondary endpoint was a composite of death, hospitalisation for HF, heart transplant, mechanical support and ventricular tachycardia/implantable cardioverter-defibrillator therapies.
RESULTS: We identified 105 out of 1721 patients (3.5%) who underwent CRT. Median follow-up after CRT implant was 4.6 (1.6-8) years. QRS improvement was limited to those with previous pacing (167±35 vs 154±28 ms; p=0.002). Following CRT, there was no significant change in B-type natriuretic peptide values, peak VO
CONCLUSION: In this retrospective study in the largest population thus far described with an sRV, CRT implant was not associated with improved survival, even after controlling for key confounders.
Area of Special Interest
Cardiovascular (Heart)
Specialty/Research Institute
Cardiology
DOI
10.1136/heartjnl-2025-326384
