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Conduction System Pacing Versus Conventional Cardiac Resynchronization Therapy in Congenital Heart Disease.
Moore, Jeremy P; de Groot, Natasja M S; O'Connor, Matthew; Cortez, Daniel; Su, Jonathan; Burrows, Austin; Shannon, Kevin M; O'Leary, Edward T; Shah, Maully; Khairy, Paul; Atallah, Joseph; Wong, Tom; Lloyd, Michael S; Taverne, Yannick J H J; Dubin, Anne M; Nielsen, Jens C; Evertz, Reinder; Czosek, Richard J; Madhavan, Malini; Chang, Philip M; Aydin, Alper; Cano, Óscar.
Afiliación
  • Moore JP; Division of Cardiology, Ahmanson/UCLA Adult Congenital Heart Disease Center, Department of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, USA; Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine, University of California-Los Angeles
  • de Groot NMS; Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
  • O'Connor M; Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
  • Cortez D; Adult Congenital Cardiology and Pediatric Cardiology, University of Minnesota, Minneapolis, Minnesota, USA; Adult Congenital Cardiology and Pediatric Cardiology, UC Davis Medical Center, Sacramento, California, USA.
  • Su J; Division of Cardiology, Department of Pediatrics, UCLA Medical Center, Los Angeles, California, USA.
  • Burrows A; David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Shannon KM; Division of Cardiology, Ahmanson/UCLA Adult Congenital Heart Disease Center, Department of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, USA; Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine, University of California-Los Angeles
  • O'Leary ET; Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
  • Shah M; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Khairy P; Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
  • Atallah J; Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
  • Wong T; Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
  • Lloyd MS; Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Taverne YJHJ; Department of Cardiothoracic Surgery, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands.
  • Dubin AM; Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA.
  • Nielsen JC; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Evertz R; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Czosek RJ; Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
  • Madhavan M; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
  • Chang PM; Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri, USA.
  • Aydin A; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
  • Cano Ó; Área de Enfermedades Cardiovasculares, Hospital Universitari i Politècnic La Fe, Centro de Investigaciones Biomédicas en RED en Enfermedades Cardiovasculares, Valencia, Spain.
JACC Clin Electrophysiol ; 9(3): 385-393, 2023 03.
Article en En | MEDLINE | ID: mdl-36752449
BACKGROUND: Dyssynchrony-associated left ventricular systolic dysfunction is a major contributor to heart failure in congenital heart disease (CHD). Although conventional cardiac resynchronization therapy (CRT) has shown benefit, the comparative efficacy of cardiac conduction system pacing (CSP) is unknown. OBJECTIVES: The purpose of this study was compare the clinical outcomes of CSP vs conventional CRT in CHD with biventricular, systemic left ventricular anatomy. METHODS: Retrospective CSP data from 7 centers were compared with propensity score-matched conventional CRT control subjects. Outcomes were lead performance, change in left ventricular ejection fraction (LVEF), and QRS duration at 12 months. RESULTS: A total of 65 CSP cases were identified (mean age 37 ± 21 years, 46% men). The most common CHDs were tetralogy of Fallot (n = 12 [19%]) and ventricular septal defect (n = 12 [19%]). CSP was achieved after a mean of 2.5 ± 1.6 attempts per procedure (38 patients with left bundle branch pacing, 17 with HBP, 10 with left ventricular septal myocardial). Left bundle branch area pacing [LBBAP] vs HBP was associated with a smaller increase in pacing threshold (Δ pacing threshold 0.2 V vs 0.8 V; P = 0.05) and similar sensing parameters at follow-up. For 25 CSP cases and control subjects with baseline left ventricular systolic dysfunction, improvement in LVEF was non-inferior (Δ LVEF 9.0% vs 6.0%; P = 0.30; 95% confidence limits: -2.9% to 10.0%) and narrowing of QRS duration was more pronounced for CSP (Δ QRS duration 35 ms vs 14 ms; P = 0.04). Complications were similar (3 [12%] CSP, 4 [16%] conventional CRT; P = 1.00). CONCLUSIONS: CSP can be reliably achieved in biventricular, systemic left ventricular CHD patients with similar improvement in LVEF and greater QRS narrowing for CSP vs conventional CRT at 1 year. Among CSP patients, pacing electrical parameters were superior for LBBAP vs HBP.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Ventricular Izquierda / Terapia de Resincronización Cardíaca / Cardiopatías Congénitas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: JACC Clin Electrophysiol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disfunción Ventricular Izquierda / Terapia de Resincronización Cardíaca / Cardiopatías Congénitas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: JACC Clin Electrophysiol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos