Cardiac resynchronization therapy in adults with congenital heart disease
| Autor: | Ahmed Krimly, Barbara J.M. Mulder, Louise Harris, Candice K. Silversides, Lieselot van Erven, Isabelle C. Van Gelder, Joris R. de Groot, Zeliha Koyak, Ulas Höke, Werner Budts, Berto J. Bouma, Erwin Oechslin, Tara M. Mackay |
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| Přispěvatelé: | Cardiovascular Centre (CVC), ACS - Amsterdam Cardiovascular Sciences, Cardiology, Graduate School, APH - Personalized Medicine, APH - Aging & Later Life, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, ACS - Heart failure & arrhythmias, ACS - Pulmonary hypertension & thrombosis |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Time Factors Heart disease medicine.medical_treatment SYSTEMIC RIGHT VENTRICLE 030204 cardiovascular system & hematology Ventricular Function Left Electrocardiography 0302 clinical medicine FAILURE Adult congenital heart disease 030212 general & internal medicine Tetralogy of Fallot Netherlands Heart transplantation education.field_of_study Cardiac resynchronization therapy Middle Aged Treatment Outcome Great arteries Echocardiography Cardiology cardiovascular system Female Cardiology and Cardiovascular Medicine BUNDLE-BRANCH BLOCK Adult Heart Defects Congenital medicine.medical_specialty Adolescent Population Clinical Decision-Making 03 medical and health sciences Young Adult MORBIDITY Physiology (medical) Internal medicine medicine Humans Cardiac Resynchronization Therapy Devices cardiovascular diseases education METAANALYSIS Aged Retrospective Studies Heart Failure ARRHYTHMIAS business.industry Patient Selection MORTALITY Retrospective cohort study Stroke Volume Recovery of Function FALLOT medicine.disease Heart failure Ventricular Function Right TETRALOGY EXPERIENCE business |
| Zdroj: | Europace, 20(2), 315-322. Oxford University Press Europace : European pacing, arrhythmias, and cardiac electrophysiology, 20(2), 315-322. Oxford University Press EP-Europace, 20(2), 315-322 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Aims In adults with congenital heart disease (CHD) heart failure is one of the leading causes of morbidity and mortality but experience with and reported outcome of cardiac resynchronization therapy (CRT) is limited. We investigated the efficacy of CRT in adults with CHD.Methods and results This was a retrospective study including 48 adults with CHD who received CRT since 2003 in four tertiary referral centres. Responders were defined as patients who showed improvement in NYHA functional class and/or systemic ventricular ejection fraction by at least one category. Ventricular function was assessed by echocardiography and graded on a four point ordinal scale. Median age at CRT was 47 years (range 18-74 years) and 77% was male. Cardiac diagnosis included tetralogy of Fallot in 29%, (congenitally corrected) transposition of great arteries in 23%, septal defects in 25%, left sided lesions in 21%, and Marfan syndrome in 2% of the patients. The median follow-up duration after CRT was 2.6 years (range 0.1-8.8). Overall, 37 out of 48 patients (77%) responded to CRT either by improvement of NYHA functional class and/or systemic ventricular function. There were 11 nonresponders to CRT. Of these, three patients died and four underwent heart transplantation.Conclusion In this cohort of older CHD patients, CRT was accomplished with a success rate comparable to those with acquired heart disease despite the complex anatomy and technical challenges frequently encountered in this population. Further studies are needed to establish appropriate guidelines for patient selection and long term outcome. |
| Databáze: | OpenAIRE |
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