Skip to main content
SpringerLink
Log in

Evaluating the response to cardiac resynchronization therapy performed with a new ventricular morphology-based strategy for congenital heart disease

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Background

In cardiac resynchronization therapy (CRT) for patients with congenital heart disease (CHD) and a ventricular morphology other than a systemic left ventricle (LV), we previously proposed pacing sites that are different from those used for a systemic LV. The leads should be placed laterally on opposite sides of both ventricles in patients with short-axis dyssynchrony and a single ventricular physiology with two ventricles, whereas they should be placed at the farthest sites along the longitudinal direction in the right ventricle (RV) in patients with long-axis dyssynchrony of the RV. Moreover, in patients with interventricular dyssynchrony and a biventricular physiology with a systemic RV, they should be placed at sites that both ventricles can contract simultaneously. We retrospectively investigated 27 consecutive procedures in 24 patients with CHD who underwent CRT to evaluate the effectiveness of a new ventricular morphology-based CRT strategy. The responder rate was 63% (17/27). The reasons for a non-response to CRT in 10 cases were as follows: non-optimal lead positions during CRT, 4; no systemic ventricular conduction delay or heart failure symptoms before the CRT, 5; short follow-up periods after the CRT, 2; and an extremely dilated systemic RV, 1. The responder rate became 88% (14/16), after excluding the procedures without a ventricular conduction delay or heart failure symptoms and those with non-optimal lead positions. This new strategy for CRT can provide favorable results for CHD patients with a systemic ventricular conduction delay and heart failure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO, American College of Cardiology F, American Heart Association Task Force on Practice G, Heart Rhythm S (2013) 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation 127:e283–e352

    Article  Google Scholar 

  2. Janousek J, Gebauer RA, Abdul-Khaliq H, Turner M, Kornyei L, Grollmuss O, Rosenthal E, Villain E, Fruh A, Paul T, Blom NA, Happonen JM, Bauersfeld U, Jacobsen JR, van den Heuvel F, Delhaas T, Papagiannis J, Trigo C (2009) Cardiac resynchronisation therapy in paediatric and congenital heart disease: differential effects in various anatomical and functional substrates. Heart 95:1165–1171

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Cecchin F, Frangini PA, Brown DW, Fynn-Thompson F, Alexander ME, Triedman JK, Gauvreau K, Walsh EP, Berul CI (2009) Cardiac resynchronization therapy (and multisite pacing) in pediatrics and congenital heart disease: 5 years experience in a single institution. J Cardiovasc Electrophysiol 20:58–65

    Article  PubMed  Google Scholar 

  4. Dubin AM, Janousek J, Rhee E, Strieper MJ, Cecchin F, Law IH, Shannon KM, Temple J, Rosenthal E, Zimmerman FJ, Davis A, Karpawich PP, Al Ahmad A, Vetter VL, Kertesz NJ, Shah M, Snyder C, Stephenson E, Emmel M, Sanatani S, Kanter R, Batra A, Collins KK (2005) Resynchronization therapy in pediatric and congenital heart disease patients: an international multicenter study. J Am Coll Cardiol 46:2277–2283

    Article  PubMed  Google Scholar 

  5. Miyazaki A, Sakaguchi H, Kagisaki K, Tsujii N, Matsuoka M, Yamamoto T, Hoashi T, Noda T, Ohuchi H (2016) Optimal pacing sites for cardiac resynchronization therapy for patients with a systemic right ventricle with or without a rudimentary left ventricle. Europace 18:100–112

    Article  PubMed  Google Scholar 

  6. Miyazaki A, Sakaguchi H, Noritake K, Hayama Y, Negishi J, Kagisaki K, Yasuda K, Ichikawa H, Ohuchi H (2017) Interventricular dyssynchrony in a patient with a biventricular physiology and a systemic right ventricle. Heart Vessels 32:234–239

    Article  PubMed  Google Scholar 

  7. Edwards WD, Maleszewski JJ (2013) Structure and function of the cardiovascular system. In: Allen HD, Driscoll DJ, Shaddy RE, Feltes T (eds) Moss & Adams heart disease in infants, children, and adolescents: including the fetus and young adult 8th. Lippincott Williams & Wilkins, a Wolters Kluwer business, Philadelphia, pp 1–31

    Google Scholar 

  8. Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 105:539–542

    Article  Google Scholar 

  9. Ishikawa T, Sumita S, Kimura K, Kikuchi M, Kosuge M, Kuji N, Endo T, Sugano T, Sigemasa T, Kobayashi I, Tochikubo O, Usui T (1999) Prediction of optimal atrioventricular delay in patients with implanted DDD pacemakers. Pacing Clin Electrophysiol 22:1365–1371

    Article  CAS  PubMed  Google Scholar 

  10. Ypenburg C, van Bommel RJ, Borleffs CJ, Bleeker GB, Boersma E, Schalij MJ, Bax JJ (2009) Long-term prognosis after cardiac resynchronization therapy is related to the extent of left ventricular reverse remodeling at midterm follow-up. J Am Coll Cardiol 53:483–490

    Article  PubMed  Google Scholar 

  11. Coppola G, Ciaramitaro G, Stabile G, Do A, Palmisano P, Carita P, Mascioli G, Pecora D, De Simone A, Marini M, Rapacciuolo A, Savarese G, Maglia G, Pepi P, Padeletti L, Pierantozzi A, Arena G, Giovannini T, Caico SI, Nugara C, Ajello L, Malacrida M, Corrado E (2016) Magnitude of QRS duration reduction after biventricular pacing identifies responders to cardiac resynchronization therapy. Int J Cardiol 221:450–455

    Article  PubMed  Google Scholar 

  12. Khairy P, Van Hare GF, Balaji S, Berul CI, Cecchin F, Cohen MI, Daniels CJ, Deal BJ, Dearani JA, Groot N, Dubin AM, Harris L, Janousek J, Kanter RJ, Karpawich PP, Perry JC, Seslar SP, Shah MJ, Silka MJ, Triedman JK, Walsh EP, Warnes CA (2014) PACES/HRS expert consensus statement on the recognition and management of arrhythmias in adult congenital heart disease: developed in partnership between the pediatric and congenital electrophysiology society (PACES) and the heart rhythm society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology (ACC), the American Heart Association (AHA), the European Heart Rhythm Association (EHRA), the Canadian Heart Rhythm Society (CHRS), and the International Society for Adult Congenital Heart Disease (ISACHD). Heart Rhythm 11:e102–e165

    Article  PubMed  Google Scholar 

  13. Kubus P, Materna O, Gebauer RA, Matejka T, Gebauer R, Tlaskal T, Janousek J (2012) Permanent epicardial pacing in children: long-term results and factors modifying outcome. Europace 14:509–514

    Article  PubMed  Google Scholar 

  14. Linde C, Ellenbogen K, McAlister FA (2012) Cardiac resynchronization therapy (CRT): clinical trials, guidelines, and target populations. Heart Rhythm 9:S3–S13

    Article  PubMed  Google Scholar 

  15. Mullens W, Grimm RA, Verga T, Dresing T, Starling RC, Wilkoff BL, Tang WH (2009) Insights from a cardiac resynchronization optimization clinic as part of a heart failure disease management program. J Am Coll Cardiol 53:765–773

    Article  PubMed  Google Scholar 

  16. Helm RH, Leclercq C, Faris OP, Ozturk C, McVeigh E, Lardo AC, Kass DA (2005) Cardiac dyssynchrony analysis using circumferential versus longitudinal strain: implications for assessing cardiac resynchronization. Circulation 111:2760–2767

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chung ES, Leon AR, Tavazzi L, Sun JP, Nihoyannopoulos P, Merlino J, Abraham WT, Ghio S, Leclercq C, Bax JJ, Yu CM, Gorcsan J 3rd, St John Sutton M, De Sutter J, Murillo J (2008) Results of the predictors of response to CRT (PROSPECT) trial. Circulation 117:2608–2616

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to express their gratitude to Mr. John Martin for his assistance in preparing the manuscript.

Funding

No grant support was received for this study

Author information

Authors and Affiliations

  1. Congenital Heart Disease Center, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 631-8552, Japan

    Aya Miyazaki & Hiraku Doi

  2. Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan

    Aya Miyazaki, Jun Negishi, Yosuke Hayama, Shigehito Baba, Yuriko Shima, Etusko Tsuda, Heima Sakaguchi & Hideo Ohuchi

  3. Department of Pediatrics, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan

    Yu Matsumura

  4. Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan

    Takaya Hoashi & Hajime Ichikawa

  5. Department of Pediatric Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan

    Koji Kagisaki

  6. Division of Arrhythmias and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan

    Takashi Noda

Authors
  1. Aya Miyazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jun Negishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yosuke Hayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shigehito Baba
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yu Matsumura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuriko Shima
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Etusko Tsuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Heima Sakaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Takaya Hoashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Koji Kagisaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Takashi Noda
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Hiraku Doi
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Hajime Ichikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Hideo Ohuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aya Miyazaki.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miyazaki, A., Negishi, J., Hayama, Y. et al. Evaluating the response to cardiac resynchronization therapy performed with a new ventricular morphology-based strategy for congenital heart disease. Heart Vessels 34, 1340–1350 (2019). https://doi.org/10.1007/s00380-019-01369-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-019-01369-2

Keywords

Search

Navigation