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Cardiac resynchronization therapy in paediatric patients with congenital heart disease: single centre with 10 years of experience

Part of: Electrophysiology

Published online by Cambridge University Press:  27 January 2021

Yakup Ergul ,
Fatma Sevinc Sengul ,
Erkut Öztürk Open the ORCID record for Erkut Öztürk [Opens in a new window] ,
Hasan C. Kafalı Open the ORCID record for Hasan C. Kafalı [Opens in a new window] ,
Pelin Ayyıldız ,
Ibrahim C. Tanıdır Open the ORCID record for Ibrahim C. Tanıdır [Opens in a new window] ,
Halil S. Akdeniz ,
Mustafa Güneş ,
Okan Yıldız  and
Sertaç Haydin
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Yakup Ergul*
Affiliation:
Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Fatma Sevinc Sengul
Affiliation:
Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Erkut Öztürk
Affiliation:
Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Hasan C. Kafalı
Affiliation:
Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Pelin Ayyıldız
Affiliation:
Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Ibrahim C. Tanıdır
Affiliation:
Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Halil S. Akdeniz
Affiliation:
Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Mustafa Güneş
Affiliation:
Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Okan Yıldız
Affiliation:
Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Sertaç Haydin
Affiliation:
Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Alper Güzeltaş
Affiliation:
Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
*
Author for correspondence: Prof. Y. Ergul, MD, Department of Pediatric Cardiology & Pediatric Electrophysiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Eğitim Araştırma Hastanesi, İstasyon Mahallesi İstanbul Caddesi Bezirganbahçe Mevki 34303 Küçükçekmece, Istanbul, Turkey. Tel: +90 212 692 20 00; Fax: +90 212 471 94 94. E-mail: yakupergul77@hotmail.com
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Abstract

Objectives:

In recent years, cardiac resynchronization therapy (CRT) has also started to be performed in the paediatric and CHD population. This study aimed to evaluate the efficacy of CRT in children with CHD.

Patients and methods:

Patients with CHD who underwent CRT treatment in our paediatric cardiology clinic between January, 2010 and January, 2020 were included in the study. Demographic findings, 12-lead electrocardiograms, echocardiograms, clinical characteristics, management strategies, and outcomes were reviewed systematically.

Results:

The study population consisted of 18 CHD patients who had been treated with CRT for 10 years in our institution. The median age was 11 years (2.2–18 years) and the median weight was 39 kg (10–81 kg). Systemic ventricle was left ventricle in 13 patients, right ventricle in 4 patients, and 1 patient had single-ventricle physiology. CRT implantation indications were as follows: dysfunction after permanent pacemaker in 11 patients, dysfunction after left bundle branch block in 4 patients, and systemic ventricular dysfunction in 3 patients. CRT implantation techniques were epicardial (n = 13), hybrid (n = 4), and transvenous (n = 1) methods. QRS duration significantly decreased after CRT implantation (160 versus 124 m/second, p < 0.05). Median systemic ventricle ejection fraction (EF) significantly increased after the procedure (30 versus 50%, p < 0.05). Fourteen patients (78%) were responders, two patients (11%) were superresponders, and two patients (11%) were non-responders after the CRT treatment. One patient deceased during follow-up. Median follow-up duration was 40 months (6–117 months).

Conclusion:

When electromechanical dyssynchrony occurs in paediatric cases with CHD and developing heart failure, patients should be evaluated in terms of CRT to improve ventricular function. Alternative CRT therapy will be beneficial in these cases that do not improve clinically despite optimal medical treatment.

Keywords

Cardiac resynchronization therapycongenital heart diseasepaediatric
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 6 , June 2021 , pp. 940 - 948
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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