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Europace Advance Access published online on February 21, 2006
Europace, doi:10.1093/europace/euj048
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© The European Society of Cardiology 2006. All rights reserved
Received June 1, 2005
Accepted November 22, 2005

Article

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

Gerhard-Paul Diller 1 *, Darlington Okonko 2, Anselm Uebing 3, Siew Yen Ho 2, and Michael A Gatzoulis 1

1 Adult Congenital Heart Programme, Royal Brompton Hospital, Sydney Street, SW3 6NP London, UK; National Heart and Lung Institute, Imperial College of Science and Medicine, London, UK
2 National Heart and Lung Institute, Imperial College of Science and Medicine, London, UK
3 Adult Congenital Heart Programme, Royal Brompton Hospital, Sydney Street, SW3 6NP London, UK; Department of Paediatric Cardiology and Biomedical Engineering, University Hospital of Schleswig-Holstein, Kiel, Germany

* To whom correspondence should be addressed.
Gerhard-Paul Diller, E-mail: g.diller{at}imperial.ac.uk


  Abstract

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.

Keywords: Congenital heart disease; Systemic right ventricle; Cardiac resynchronization therapy.
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