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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Influence of diabetes on cardiac resynchronization therapy with or without defibrillator in patients with advanced

Jalal K Ghali1, John Boehmer, Arthur M Feldman

  • 1Wayne State University School of Medicine, Detroit, Michigan 48201, USA.

Journal of Cardiac Failure
|November 13, 2007
PubMed

Insights

Cardiac resynchronization therapy (CRT) significantly benefits diabetic patients with advanced heart failure (HF), reducing mortality and hospitalizations. Device therapy improved all measured endpoints compared to optimal pharmacologic therapy alone.

Area of Science:

  • Cardiology
  • Medical Devices
  • Diabetes Mellitus

Background:

  • Diabetes is an independent predictor of morbidity and mortality in systolic heart failure (HF).
  • Limited data exist on the impact of cardiac resynchronization therapy (CRT) in diabetic patients with advanced HF.

Purpose of the Study:

  • To determine the influence of CRT with a defibrillator (CRT-D) or without a defibrillator (CRT-P) on outcomes in diabetic patients with advanced HF.
  • To analyze the impact of CRT on mortality and hospitalization rates in this patient group.

Main Methods:

  • Post hoc analysis of the Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure trial.
  • Examined outcomes in 622 diabetic patients receiving CRT (CRT-D or CRT-P) versus optimal pharmacologic therapy.
  • Utilized Cox proportional hazard models to adjust for numerous clinical and demographic variables.

Main Results:

  • Diabetic patients receiving CRT showed substantial reductions in all-cause mortality or hospitalization (HR=0.77), all-cause mortality or cardiovascular hospitalization (HR=0.67), all-cause mortality or HF hospitalization (HR=0.52), and all-cause mortality (HR=0.67).
  • Outcomes for diabetic patients with CRT were significantly improved compared to optimal pharmacologic therapy.
  • Procedure-related complications and length of stay were similar between diabetic and nondiabetic patients.

Conclusions:

  • CRT device therapy offers substantial benefits for diabetic patients with advanced HF.
  • Significant improvements in all analyzed endpoints were observed in diabetic patients treated with CRT.
  • CRT is a valuable therapeutic option for improving outcomes in this high-risk population.
Abstract

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