Cardiac resynchronization therapy among adults with a systemic right ventricle: a multicenter experience

作者：Flavia Fusco, Giancarlo Scognamiglio, Mikael Dellborg, Payam Dehghani, Susan M. Jameson, W. Aaron Kay, Jonathan Cramer, Isabelle Vonder Muhll, Eric V. Krieger, Fred H. Rodriguez, Luke J. Burchill, Jeremy Nicolarsen, Joseph Kay, Robert M. Kauling, Sangeeta Shah, Anthony Magalski, Joshua Wong, David S. Celermajer, David W. Baker, Jolien W. Roos‐Hesselink, Salil Ginde, Jamil Aboulhosn, Marissa C. Kuo, Christopher DeZorzi, Paul Khairy, Carla P. Rodriguez Monserrate, Shelby Kutty, William Wilson, Adam M. Lubert, Jasmine Grewal, Frank Han, Timothy B. Cotts, Stephen Pylypchuk, Tripti Gupta, Petra Antonová, Clare O’Donnell, Anitha S. John, Pastora Gallego, Alexandra C. van Dissel, Alexander R. Opotowsky, Elizabeth Yeung, Craig S. Broberg, Berardo Sarubbi · 发表于：medRxiv · 年份：2025 · DOI：10.1101/2025.03.06.25323532 · 被引用次数：2 · 研究领域：Cardiac pacing and defibrillation studies、Cardiac Arrhythmias and Treatments

Abstract Background Cardiac Resynchronization 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 analysis was part of an international, retrospective study of data from 33 centers including patients >18years with transposition of the great arteries (TGA) following atrial switch operation and congenitally corrected TGA (ccTGA). The primary endpoint was overall survival. The secondary endpoint was a composite of death, hospitalization for HF, heart transplant, mechanical support, ventricular tachycardia/ICD therapies. Results We identified 105 out of 1,721 patients(3.5%) who underwent CRT. Median follow-up after CRT implant was 4.6 [1.6-8] years. There was no overall QRS improvement (157±37 Vs 153±31 ms; p=0.2), which 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, peakVO 2 , tricuspid regurgitation severity by echocardiography. CRT complications occurred in 10 (9.5%), though there were usually minor. Patients with CRT were propensity-matched to controls according to age, sex, morphology (ccTGA/TGA), presence of complex disease, previous HF admission and sRV dysfunction at baseline. At univariable analysis, CRT (OR 4.02-95% CI:1.48-10.8...