Predictors of Response to Cardiac Resynchronization Therapy in Pediatric Patients and Patients With Congenital Heart Disease
Authors' conclusion
CRT in children and patients with congenital heart disease frequently results in an improvement in SVEF. Those with lower SVEF, conduction delay to the lateral wall of the systemic ventricle, and those with a systemic left ventricle are most likely to respond.
Study context
- Population
- Patients aged <21 or with congenital heart disease, systemic ventricular ejection fraction (SVEF) <45%, symptomatic HF and significant electrical dyssynchrony before cardiac resynchronization therapy (CRT)150 with comprehensive data
- Participants
- 167 patients
- Exposure
- Predictors of response to CRT
- Improved SVEFn = 96
- Unchanged SVEFn = 26
- Worse SVEFn = 28
- Outcome
- Ordinal response: improved SVEF (≥5%), unchanged SVEF, worse SVEF
- Follow-up
- 6 or 12 months
Methodological details5 quaternary referral centres, propensity score-matched control cohort (secondary outcome)
- 5 quaternary referral centres
- Propensity score-matched control cohort (secondary outcome)
Main finding
As reported in the abstract
Ordinal SVEF response
- Lower SVEF associated with positive response (univariable ordinal regression)
- P = 0.013
- Biventricular circulation associated with positive response
- P = 0.022
- Systemic LV associated with positive response
- P = 0.021
- Conduction delay to lateral wall of systemic ventricle associated with positive response
- P = 0.01
Observational data: associations, not effects.
Secondary outcomes
Longitudinal SVEF trajectory vs propensity score-matched controls (n=324), by subgroup · median follow-up 5.1 (IQR 2.0-8.6) years
- No improvement: systemic RV
- P = 0.69
- No improvement: without prior single-site pacemaker
- P = 0.20
- Almost all subgroups showed improved SVEF trend with CRT
Original publication
Predictors of Response to Cardiac Resynchronization Therapy in Pediatric Patients and Patients With Congenital Heart Disease. Circ Arrhythm Electrophysiol. Published 2 December 2025. doi:10.
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