{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T11:29:23Z","timestamp":1776511763656,"version":"3.51.2"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Cardiac resynchronization therapy (CRT) is an important therapeutic option in selected pediatric patients and patients with congenital heart disease with reduced systemic ventricular ejection fraction (SVEF). However, the identification of optimal responders is challenging. This study aimed to identify predictors of response to CRT in children and patients with congenital heart disease at 5 large quaternary referral centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Patients were aged &lt;21 or had congenital heart disease and had SVEF &lt;45%, symptomatic heart failure, and significant electrical dyssynchrony before CRT. Primary outcome was defined as an ordinal response at 6 or 12 months: (1) improved SVEF (\u22655%), (2) unchanged SVEF, and (3) worse SVEF. Secondary outcome utilized a propensity score\u2013matched control cohort. Response to CRT was defined using the longitudinal trajectory of SVEF up to the latest follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      In total, 167 eligible CRT recipients were identified across the 5 centers; 150 had comprehensive data at 6 or 12 months: 96 (64%) with improved SVEF, 26 (17%) unchanged, and 28 (19%) worsened. Mean increase in SVEF was 11% (interquartile range, 3%\u201321%). On univariable ordinal regression, lower SVEF (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.013), biventricular circulation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.022), systemic left ventricle (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.021), and conduction delay to the lateral wall of the systemic ventricle (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.01) were associated with a positive response. For the assessment of the secondary outcome, 324 controls were identified. Median follow-up is 5.1 (interquartile range, 2.0\u20138.6) years. Almost all subgroups demonstrated improved SVEF trend with CRT, except those with systemic right ventricle (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.69) or without prior single-site pacemaker (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.20).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.124.013600","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T10:02:56Z","timestamp":1764669776000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of Response to Cardiac Resynchronization Therapy in Pediatric Patients and Patients With Congenital Heart Disease"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2859-3536","authenticated-orcid":true,"given":"Henry","family":"Chubb","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics (H.C., W.G., S.R.C., K.S.M., D.N.R., C.S.A., D.B.M., A.M.D.), Stanford University, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9374-2171","authenticated-orcid":true,"given":"Douglas","family":"Mah","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital and Department of Pediatrics, Harvard Medical School, MA (D.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4743-6915","authenticated-orcid":true,"given":"Maully","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Children\u2019s Hospital of Philadelphia, PA (M.S., K.Y.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1582-9797","authenticated-orcid":true,"given":"Kimberly Y.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Children\u2019s Hospital of Philadelphia, PA (M.S., K.Y.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7763-7518","authenticated-orcid":true,"given":"David","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, CS Mott Children\u2019s Hospital, University of Michigan, Ann Arbor (D.P., B.W.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5613-9808","authenticated-orcid":true,"given":"Benjamin W.","family":"Hale","sequence":"additional","affiliation":[{"name":"Department of Cardiology, CS Mott Children\u2019s Hospital, University of Michigan, Ann Arbor (D.P., B.W.H.)."},{"name":"Department of Pediatrics, Stead Family Children\u2019s Hospital, Iowa City, IA (B.W.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0851-7496","authenticated-orcid":true,"given":"Lindsay","family":"May","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Primary Children\u2019s Hospital, The University of Utah, Salt Lake City (L.M., S.E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2492-422X","authenticated-orcid":true,"given":"Susan","family":"Etheridge","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Primary Children\u2019s Hospital, The University of Utah, Salt Lake City (L.M., S.E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3252-1180","authenticated-orcid":true,"given":"William","family":"Goodyer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics (H.C., W.G., S.R.C., K.S.M., D.N.R., C.S.A., D.B.M., A.M.D.), Stanford University, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9473-0105","authenticated-orcid":true,"given":"Scott 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