Background

Although patients with systemic right ventricle (SRV) represent a significant proportion of patients with congenital heart disease (CHD) implanted with cardiac resynchronization therapy (CRT), there are limited and conflicting data in this specific patient group.

Objective

We aimed to analyze outcomes of patients with SRV implanted with a CRT device.

Methods

Data were analyzed from an observational, retrospective, multicenter cohort study including all patients with CHD implanted with a CRT device from 6 French centers from 2004 to 2020. Response to CRT was defined as an increase in systemic ventricular ejection fraction of ≥10% and/or an improvement in New York Heart Association functional class by at least 1 grade.

Results

A total of 85 patients with CHD were enrolled (mean age 39.8 ± 20.0 years; 55 [64.7%] males; 25 defibrillators [29.4%]), including 31 patients with SRV (36.5%) (mean age 43.9 ± 19.8 years; 16 [51.6%] males). The mean change in QRS duration after implantation was similar as compared with patients with systemic left ventricle (−46 ± 26 ms vs −35 ± 32 ms; P = .16). During a mean follow-up of 5.1 ± 3.5 years, late complications included 2 lead dysfunctions (6.5%), 3 CRT-related infections (9.7%), and 1 inappropriate implantable cardioverter-defibrillator shock (3.2%). The proportion of CRT responders at 6, 12, and 24 months were 82.6%, 80.0%, and 77.8% in patients with SRV vs 66.7%, 64.3%, and 69.6% in patients with systemic left ventricle (P = NS).

Conclusion

In this multicenter cohort, one-third of patients with CHD implanted with a CRT device had SRV. CRT in patients with SRV was associated with a high rate of responders, comparable to that of patients with systemic left ventricle.

中文翻译：

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先天性心脏病合并全身性右心室患者的心脏再同步化治疗

背景

尽管全身性右心室 (SRV) 患者在植入心脏再同步化治疗 (CRT) 的先天性心脏病 (CHD) 患者中占很大比例，但在这一特定患者组中的数据有限且相互矛盾。

客观的

我们旨在分析 SRV 患者植入 CRT 装置的结果。

方法

数据分析来自一项观察性、回顾性、多中心队列研究，包括 2004 年至 2020 年来自 6 个法国中心的所有植入 CRT 装置的 CHD 患者。对 CRT的反应定义为全身心室射血分数增加≥10% 和/或纽约心脏协会功能等级至少提高 1 级。

结果

共招募了 85 名 CHD 患者（平均年龄 39.8 ± 20.0 岁；55 [64.7%] 男性；25 台除颤器 [29.4%]），其中 31 名 SRV 患者（36.5%）（平均年龄 43.9 ± 19.8 岁；16 [51.6%] 男性）。与全身性左心室患者相比，植入后 QRS 持续时间的平均变化相似（-46 ± 26 ms 对比 -35 ± 32 ms；P = .16）。在平均 5.1 ± 3.5 年的随访期间，晚期并发症包括 2 例导联功能障碍 (6.5%)、3 例 CRT 相关感染 (9.7%) 和 1 例不适当的植入式心脏复律除颤器休克 (3.2%)。SRV 患者在 6、12 和 24 个月时 CRT 反应的比例分别为 82.6%、80.0% 和 77.8%，而全身性左心室患者分别为 66.7%、64.3% 和 69.6%（P = NS）。

结论

在这个多中心队列中，三分之一植入 CRT 装置的 CHD 患者患有 SRV。SRV 患者的 CRT 与高反应率相关，与全身性左心室患者相当。