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

  • Aya MiyazakiEmail author
  • Jun Negishi
  • Yosuke Hayama
  • Shigehito Baba
  • Yu Matsumura
  • Yuriko Shima
  • Etusko Tsuda
  • Heima Sakaguchi
  • Takaya Hoashi
  • Koji Kagisaki
  • Takashi Noda
  • Hiraku Doi
  • Hajime Ichikawa
  • Hideo Ohuchi
Original Article

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.

Keywords

Congenital heart disease Cardiac resynchronization therapy Ventricular morphology Responder rate Non-responder 

Notes

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

Compliance with ethical standards

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.

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Aya Miyazaki
    • 1
    • 2
    Email author
  • Jun Negishi
    • 2
  • Yosuke Hayama
    • 2
  • Shigehito Baba
    • 2
  • Yu Matsumura
    • 3
  • Yuriko Shima
    • 2
  • Etusko Tsuda
    • 2
  • Heima Sakaguchi
    • 2
  • Takaya Hoashi
    • 4
  • Koji Kagisaki
    • 5
  • Takashi Noda
    • 6
  • Hiraku Doi
    • 1
  • Hajime Ichikawa
    • 4
  • Hideo Ohuchi
    • 2
  1. 1.Congenital Heart Disease CenterTenri HospitalTenriJapan
  2. 2.Department of Pediatric CardiologyNational Cerebral and Cardiovascular CenterSuitaJapan
  3. 3.Department of PediatricsTsuchiura Kyodo General HospitalTsuchiuraJapan
  4. 4.Department of Pediatric Cardiovascular SurgeryNational Cerebral and Cardiovascular CenterSuitaJapan
  5. 5.Department of Pediatric Cardiovascular SurgeryOsaka City General HospitalOsakaJapan
  6. 6.Division of Arrhythmias and Electrophysiology, Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan

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