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Europace Advance Access originally published online on February 21, 2006
Europace 2006 8(4):267-272; doi:10.1093/europace/euj048
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

CRT

Cardiac resynchronization therapy for adult congenital heart disease patients with a systemic right ventricle: analysis of feasibility and review of early experience

Gerhard-Paul Diller1,2,*, Darlington Okonko2, Anselm Uebing1,3, Siew Yen Ho2 and Michael A. Gatzoulis1,2

1 Adult Congenital Heart ProgrammeRoyal Brompton HospitalSydney Street, SW3 6NP London UK; 2 National Heart and Lung InstituteImperial College of Science and MedicineLondon UK; 3 Department of Paediatric Cardiology and Biomedical EngineeringUniversity Hospital of Schleswig-HolsteinKiel Germany

Aims 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.

Methods and 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.

Conclusion 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.

Key Words: Congenital heart disease, Systemic right ventricle, Cardiac resynchronization therapy

* Corresponding author. Tel: +44 207 351 8600; fax: +44 207 351 8629. E-mail address: g.diller{at}imperial.ac.uk


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