Abstract
Patients with corrected tetralogy of Fallot (TF) often suffer from symptomatic right ventricular failure always associated with right bundle branch block (RBBB) on resting ECG. Our objective was to evaluate the mid-term safety and efficacy of cardiac resynchronization (CRT) in this population. We collected retrospectively every adverse events due to biventricular pacing of patients with corrected tetralogy of Fallot implanted with CRT system in our department. We also compared clinical datas (NYHA score), stress tests, ECG, echocardiographic results before implantation, at 6 months of follow-up and at the last evaluation. From August 2005 to Septembre 2009, 9 patients were implanted with CRT system, 6 (66,7%) with transvenous leads and 3 (33,4%) with epicardic leads, mostly composed of men (6, 66,7%) with a mean age of 34,2±14,5 years, 4 (44,5%) had an Implantable Cardioverter Defibrillator (ICD) function. During a median follow-up of 65 months [50-80], no main adverse event was reported, we had 1 atrial lead dislogement, 3 (33%) lead disfunctions causing only 1 (11%) resynchronisation failure and 1 (11%) intermittent phrenic nerve stimulation. CRT were associated with lower NHYA score (1,4±0,52 then 1,3±0,8 vs 2±0,4, p<0,05) and an improved exercise tolerance (100±21,6W then 112,9±12,9W, vs. 71,3±26,2W, p<0,05) at 6 months and at the end of follow-up. Mean RVEF was increased (54,3±8,2 vs. 38,5±7,5; p=0,035 and so was LVEF (53,8±8,3% vs. 48,8±8,8%, p=0,04). CRT in corrected tetralogy of Fallot anad right ventricule failure is safe and seems to be associated with an improvement of patient’s functional status. This first study on CRT in this population should be confirmed by a large prospective randomised multicentric clinical trial.
Published Version
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