Cardiac resynchronisation therapy among adults with a systemic right ventricle: a multicentre experience
Authors' conclusion
In this retrospective study in the largest population thus far described with an sRV, CRT implant was not associated with improved survival, even after controlling for key confounders.
Study context
- Population
- Patients >18 years with transposition of the great arteries (TGA) following atrial switch operation and congenitally corrected TGA, with a systemic right ventricle (sRV)out of 1721 patients (3.5%) who underwent cardiac resynchronisation therapy (CRT)
- Participants
- 105 patients
- Exposure
- Patients with CRT propensity-matched to controls
- CRTn = 105
- Outcome
- Overall survival and survival free from HF
- Follow-up
- Median after CRT implant 4.6 (1.6-8) years
Methodological details33 centres, propensity-matched to controls
- 33 centres
- Propensity-matched to controls
Main finding
As reported in the abstract
CRT vs controlsHazard ratio (95% CI)P value
Univariable; predictive of death
4.39(1.6–11.9)
P = 0.003Univariable; associated with HF admission
3(1.3–7)
P = 0.01Multivariable; independently associated with poorer outcome
8.8(2.9–26.6)
P = 0.0001- Age, multivariable HR (95% CI 1.01 to 1.15; p<0.0001), independently associated with poorer outcome
- 1.1%
Observational data: associations, not effects.
Secondary outcomes
QRS duration
- QRS improvement limited to those with previous pacing
- 167±35 vs 154±28 ms; p=0.002
B-type natriuretic peptide, peak VO 2, tricuspid regurgitation severity · Following CRT
- No significant change
Safety
- CRT complications
- 9.5% · 10 of 105
Original publication
Cardiac resynchronisation therapy among adults with a systemic right ventricle: a multicentre experience. Heart. Published 5 November 2025. doi:10.
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