{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T19:23:21Z","timestamp":1773343401822,"version":"3.50.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to evaluate the mid-term outcomes of cardiac resynchronization therapy (CRT) in patients with single ventricle (SV), heart failure, and ventricular dyssynchrony, which leads to heart failure and poor outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed patients with SV who underwent CRT at our institution between 2010 and 2024. Dyssynchrony was defined as QRS duration \u2265130 ms and qualitative mechanical dyssynchrony between the main and rudimentary ventricles assessed by echocardiography and cine-angiography. Cardiac resynchronization therapy indications were based on acute haemodynamic studies (shortened QRS duration and increased peak dP\/dt). The patients were divided into Groups G (CRT after bidirectional Glenn) and F (after Fontan completion). Haemodynamic parameters, NYHA class, brain natriuretic peptide, survival, Fontan completion rate, and hepatic function were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Group G included 9 and Group F included 11 patients. One year after CRT, the systemic ventricular ejection fraction improved in Groups G (30%-40%, P\u2009=\u2009.006) and F (30%-53%, P\u2009=\u2009.001), with corresponding increases in cardiac index and NYHA class. The median follow-up was 6.7 years (Group G) and 7.6 years (Group F). The 5-year survival rates were 89% and 82%, respectively. The Fontan completion rate was 76% at 5 years in Group G. In Group F, brain natriuretic peptide levels improved, hepatic function remained stable, and no protein-losing enteropathy was reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cardiac resynchronization therapy improved systemic ventricular function and heart failure symptoms. Cardiac resynchronization therapy might be a viable therapeutic option for patients with SV, ventricular dyssynchrony, and heart failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezag105","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:51:27Z","timestamp":1771505487000},"source":"Crossref","is-referenced-by-count":0,"title":["Cardiac Resynchronization Therapy for Failing Single Ventricle Physiology"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3832-4919","authenticated-orcid":false,"given":"Yuji","family":"Tominaga","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Centre , Osaka, 565-8565,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7758-840X","authenticated-orcid":false,"given":"Heima","family":"Sakaguchi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, National Cerebral and Cardiovascular Centre , Osaka, 565-8565,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Takeshita","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Centre , Osaka, 565-8565,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuji","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Centre , Osaka, 565-8565,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Shibagaki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Centre , Osaka, 565-8565,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaya","family":"Nakamizo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Centre , Osaka, 565-8565,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Kurosaki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, National Cerebral and Cardiovascular Centre , Osaka, 565-8565,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigemitsu","family":"Iwai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Centre , Osaka, 565-8565,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"2026031206214339500_ezag105-B1","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12968-023-00984-3","article-title":"Ventricular dyssynchrony late after the Fontan operation is associated with decreased survival","volume":"25","author":"Gearhart","year":"2023","journal-title":"J Cardiovasc Magn Reson"},{"key":"2026031206214339500_ezag105-B2","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1177\/21501351241227882","article-title":"Impact of the rudimentary chamber on outcomes in Fontan patients","volume":"15","author":"Miwa","year":"2024","journal-title":"World J Pediatr Congenit Heart Surg"},{"key":"2026031206214339500_ezag105-B3","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/s0002-9149(98)00244-6","article-title":"Regional ventricular systolic abnormalities caused by a rudimentary chamber in patients with univentricular hearts","volume":"82","author":"Kurotobi","year":"1998","journal-title":"Am J Cardiol"},{"key":"2026031206214339500_ezag105-B4","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.jjcc.2012.12.012","article-title":"Low-dose dobutamine induces left ventricular mechanical dyssynchrony in patients with dilated cardiomyopathy and a narrow QRS: a study using real-time three-dimensional echocardiography","volume":"61","author":"Yagishita-Tagawa","year":"2013","journal-title":"J Cardiol"},{"key":"2026031206214339500_ezag105-B5","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1016\/j.healun.2021.01.011","article-title":"Systemic ventricular assist device support in Fontan patients: a report by ACTION","volume":"40","author":"Cedars","year":"2021","journal-title":"J Heart Lung Transplant"},{"key":"2026031206214339500_ezag105-B6","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1093\/icvts\/ivx066","article-title":"Ventricular assist device support in patients with single ventricles: the Melbourne experience","volume":"25","author":"Poh","year":"2017","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2026031206214339500_ezag105-B7","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1056\/NEJM200103223441202","article-title":"Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay","volume":"344","author":"Cazeau","year":"2001","journal-title":"N Engl J Med"},{"key":"2026031206214339500_ezag105-B8","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1016\/j.jacep.2018.07.004","article-title":"Dual-site ventricular pacing in patients with Fontan physiology and heart block: does it mitigate the detrimental effects of single-site ventricular pacing?","volume":"4","author":"O\u2019Leary","year":"2018","journal-title":"JACC Clin Electrophysiol"},{"key":"2026031206214339500_ezag105-B9","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1002\/joa3.12832","article-title":"Long-term outcomes of pacemaker implantation in children with univentricular versus complex biventricular surgical repair","volume":"39","author":"Spentzou","year":"2023","journal-title":"J Arrhythm"},{"key":"2026031206214339500_ezag105-B10","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1253\/circj.CJ-14-0395","article-title":"Cardiac resynchronization therapy for various systemic ventricular morphologies in patients with congenital heart disease","volume":"79","author":"Sakaguchi","year":"2015","journal-title":"Circ J"},{"key":"2026031206214339500_ezag105-B11","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1007\/s00380-019-01369-2","article-title":"Evaluating the response to cardiac resynchronization therapy performed with a new ventricular morphology-based strategy for congenital heart disease","volume":"34","author":"Miyazaki","year":"2019","journal-title":"Heart Vessels"},{"key":"2026031206214339500_ezag105-B12","doi-asserted-by":"publisher","first-page":"e007925","DOI":"10.1161\/CIRCEP.119.007925","article-title":"Impact of cardiac resynchronization therapy on heart transplant-free survival in pediatric and congenital heart disease patients","volume":"13","author":"Chubb","year":"2020","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2026031206214339500_ezag105-B13","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.ahj.2020.09.018","article-title":"Cardiac resynchronization therapy improves the ventricular function of patients with Fontan physiology","volume":"230","author":"Joyce","year":"2020","journal-title":"Am Heart J"},{"key":"2026031206214339500_ezag105-B14","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1136\/heartjnl-2022-321435","article-title":"Haemodynamic and prognostic associations of liver fibrosis scores in Fontan-associated liver disease","volume":"109","author":"Martin de Miguel","year":"2023","journal-title":"Heart"},{"key":"2026031206214339500_ezag105-B15","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.1016\/j.jacc.2005.05.096","article-title":"Resynchronization therapy in pediatric and congenital heart disease patients: an international multicenter study","volume":"46","author":"Dubin","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"2026031206214339500_ezag105-B16","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1016\/j.hrthm.2021.11.032","article-title":"Cardiac resynchronization therapy in patients with congenital heart disease and systemic right ventricle","volume":"19","author":"Jacquemart","year":"2022","journal-title":"Heart Rhythm"},{"key":"2026031206214339500_ezag105-B17","first-page":"ezaa310","article-title":"Evaluation of Fontan failure by classifying the severity of Fontan-associated liver disease: a single-Centre cross-sectional study","volume":"28","author":"Schleiger","year":"2020","journal-title":"Eur J Cardiothorac Surg."},{"key":"2026031206214339500_ezag105-B18","doi-asserted-by":"publisher","first-page":"3173","DOI":"10.1016\/j.jacc.2017.10.045","article-title":"Fontan-associated liver disease: proceedings from the American College of Cardiology stakeholders meeting, October 1 to 2, 2015, Washington DC","volume":"70","author":"Daniels","year":"2017","journal-title":"Am Coll Cardiol"},{"key":"2026031206214339500_ezag105-B19","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1016\/j.athoracsur.2023.05.046","article-title":"Impact of ventricular dysfunction and atrioventricular valve regurgitation on pre-Fontan attrition","volume":"116","author":"Stack","year":"2023","journal-title":"Ann Thorac Surg"},{"key":"2026031206214339500_ezag105-B20","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.ejcts.2010.01.031","article-title":"Fontan completion rate and outcomes after bidirectional cavo-pulmonary shunt","volume":"38","author":"Tan","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026031206214339500_ezag105-B21","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.1016\/j.hrthm.2025.10.030","article-title":"Optimization of pacing for patients receiving ineffective cardiac resynchronization therapy","volume":"23","author":"Ueda","year":"2026","journal-title":"Heart Rhythm"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezag105\/67024259\/ezag105.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/68\/3\/ezag105\/67024259\/ezag105.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/68\/3\/ezag105\/67024259\/ezag105.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T10:21:50Z","timestamp":1773310910000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezag105\/8493209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,20]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,10]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezag105","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,2,20]]},"article-number":"ezag105"}}