Imperial College London


Faculty of MedicineNational Heart & Lung Institute

Reader in Adult Congenital Heart Disease



+44 (0)20 7351 8803s.babu-narayan




NIHR Cardiovascular Biomedical RChelsea WingRoyal Brompton Campus






BibTex format

author = {Li, W and Yin, Y and Dimopoulos, K and Shimada, E and Lascelles, K and Griffiths, S and Wong, T and Gatzoulis, M and Babu-Narayan, S},
doi = {10.1161/JAHA.119.012744},
journal = {Journal of the American Heart Association},
title = {Early and late effects of cardiac resynchronization therapy in adult congenital heart disease},
url = {},
volume = {8},
year = {2019}

RIS format (EndNote, RefMan)

AB - Background: There are limited data regarding cardiac resynchronization therapy (CRT) in adult congenital heart disease (ACHD). We aimed to assess early and late outcomes of CRT amongst patients with ACHD.Methods: We retrospectively studied ACHD patients receiving CRT (2004-2017). Clinical and echocardiographic data were analyzed at baseline, early (1.8±0.8 years) and late (4.7±0.8 years) follow-up after CRT.Results: Fifty-four ACHD patients (median age 46 years, range 18-73 years, 74% male) had CRT (biventricular paced >90%) and were followed for 5.7±3.0 years. Compared to baseline, CRT was associated with significant improvement at early follow-up in NYHA functional class, QRS duration and cardiothoracic ratio (P<0.05 for all); improvement in NYHA class was sustained at late follow-up.Amongst patients with a systemic left ventricle (LV; n=39), there was significant increase in LV ejection fraction (LVEF) and reduction in LV end-systolic volume at early and late follow up (P<0.05 for both). For patients with a systemic right ventricle (RV; n=15), there was a significant early but not late reduction in systemic RV basal and longitudinal diameters.Eleven patients died and 2 had heart transplantation unrelated to systemic ventricular morphology. Thirty-five (65%) patients responded positively to CRT but only baseline QRS duration was predictive of a positive response.Conclusions: CRT results in sustained improvement in functional class, systemic LV size and function. Patients with a systemic LV and prolonged QRS duration, independent of QRS morphology, were most likely to respond to CRT.
AU - Li,W
AU - Yin,Y
AU - Dimopoulos,K
AU - Shimada,E
AU - Lascelles,K
AU - Griffiths,S
AU - Wong,T
AU - Gatzoulis,M
AU - Babu-Narayan,S
DO - 10.1161/JAHA.119.012744
PY - 2019///
SN - 2047-9980
TI - Early and late effects of cardiac resynchronization therapy in adult congenital heart disease
T2 - Journal of the American Heart Association
UR -
UR -
VL - 8
ER -