PMID- 19307198
OWN - NLM
STAT- MEDLINE
DCOM- 20090813
LR  - 20211020
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 95
IP  - 14
DP  - 2009 Jul
TI  - Cardiac resynchronisation therapy in paediatric and congenital heart disease: 
      differential effects in various anatomical and functional substrates.
PG  - 1165-71
LID - 10.1136/hrt.2008.160465 [doi]
AB  - BACKGROUND: Cardiac resynchronisation therapy (CRT) is increasingly used in 
      children in a variety of anatomical and pathophysiological conditions, but 
      published data are scarce. OBJECTIVE: To record current practice and results of 
      CRT in paediatric and congenital heart disease. DESIGN: Retrospective multicentre 
      European survey. SETTING: Paediatric cardiology and cardiac surgery centres. 
      PATIENTS: One hundred and nine patients aged 0.24-73.8 (median 16.9) years with 
      structural congenital heart disease (n = 87), congenital atrioventricular block 
      (n = 12) and dilated cardiomyopathy (n = 10) with systemic left (n = 69), right 
      (n = 36) or single (n = 4) ventricular dysfunction and ventricular dyssynchrony 
      during sinus rhythm (n = 25) or associated with pacing (n = 84). INTERVENTIONS: 
      CRT for a median period of 7.5 months (concurrent cardiac surgery in 16/109). 
      MAIN OUTCOME MEASURES: Functional improvement and echocardiographic change in 
      systemic ventricular function. RESULTS: The z score of the systemic ventricular 
      end-diastolic dimension decreased by median 1.1 (p<0.001). Ejection fraction (EF) 
      or fractional area of change increased by a mean (SD) of 11.5 (14.3)% (p<0.001) 
      and New York Heart Association (NYHA) class improved by median 1.0 grade 
      (p<0.001). Non-response to CRT (18.5%) was multivariably predicted by the 
      presence of primary dilated cardiomyopathy (p = 0.002) and poor NYHA class (p = 
      0.003). Presence of a systemic left ventricle was the strongest multivariable 
      predictor of improvement in EF/fractional area of change (p<0.001). Results were 
      independent of the number of patients treated in each contributing centre. 
      CONCLUSION: Heart failure associated with ventricular pacing is the largest 
      indication for CRT in paediatric and congenital heart disease. CRT efficacy 
      varies widely with the underlying anatomical and pathophysiological substrate.
FAU - Janousek, J
AU  - Janousek J
AD  - Department of Paediatric Cardiology, University of Leipzig, Heart Centre, 
      Strumpellstrasse 39, 04289 Leipzig, Germany. jan.janousek@medizin.uni-leipzig.de
FAU - Gebauer, R A
AU  - Gebauer RA
FAU - Abdul-Khaliq, H
AU  - Abdul-Khaliq H
FAU - Turner, M
AU  - Turner M
FAU - Kornyei, L
AU  - Kornyei L
FAU - Grollmuss, O
AU  - Grollmuss O
FAU - Rosenthal, E
AU  - Rosenthal E
FAU - Villain, E
AU  - Villain E
FAU - Fruh, A
AU  - Fruh A
FAU - Paul, T
AU  - Paul T
FAU - Blom, N A
AU  - Blom NA
FAU - Happonen, J-M
AU  - Happonen JM
FAU - Bauersfeld, U
AU  - Bauersfeld U
FAU - Jacobsen, J R
AU  - Jacobsen JR
FAU - van den Heuvel, F
AU  - van den Heuvel F
FAU - Delhaas, T
AU  - Delhaas T
FAU - Papagiannis, J
AU  - Papagiannis J
FAU - Trigo, C
AU  - Trigo C
CN  - Working Group for Cardiac Dysrhythmias and Electrophysiology of the Association 
      for European Paediatric Cardiology
LA  - eng
GR  - F31 NR009472/NR/NINR NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20090322
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Arrhythmias, Cardiac/etiology/physiopathology/*therapy
MH  - *Cardiac Pacing, Artificial
MH  - Cardiomyopathy, Dilated/*complications/physiopathology
MH  - Child
MH  - Child, Preschool
MH  - Echocardiography
MH  - Heart Defects, Congenital/*complications/physiopathology
MH  - Heart Transplantation/statistics & numerical data
MH  - Humans
MH  - Infant
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/etiology/therapy
MH  - Pacemaker, Artificial
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Ventricular Remodeling
MH  - Young Adult
PMC - PMC2699215
COIS- Competing interests: None.
EDAT- 2009/03/25 09:00
MHDA- 2009/08/14 09:00
PMCR- 2009/03/22
CRDT- 2009/03/25 09:00
PHST- 2009/03/25 09:00 [entrez]
PHST- 2009/03/25 09:00 [pubmed]
PHST- 2009/08/14 09:00 [medline]
PHST- 2009/03/22 00:00 [pmc-release]
AID - hrt.2008.160465 [pii]
AID - ht160465 [pii]
AID - 10.1136/hrt.2008.160465 [doi]
PST - ppublish
SO  - Heart. 2009 Jul;95(14):1165-71. doi: 10.1136/hrt.2008.160465. Epub 2009 Mar 22.