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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

Mortality in patients with heart failure treated with cardiac resynchronisation therapy. A long-term multi-centre

Maciej Sterliński1, Aleksander Maciag, Oskar Kowalski

  • 12nd Department of Coronary Heart Disease, National Institute of Cardiology, Poland. msterlinski@poczta.onet.pl

Kardiologia Polska
|December 7, 2007
PubMed

Insights

Sudden cardiac death risk is highest in the first year for cardiac resynchronisation therapy pacing-only (CRT-P) patients. Heart failure deaths increase later, suggesting prophylactic defibrillation for eligible CRT patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Cardiac resynchronisation therapy (CRT) improves survival in selected congestive heart failure (CHF) patients per 2005 ESC guidelines.
  • CRT pacing-only (CRT-P) is an established treatment for specific heart failure populations.

Purpose of the Study:

  • To analyze mortality rates and causes of death in patients receiving CRT-P.
  • To evaluate the temporal pattern of mortality in CRT-P recipients over at least one year.

Main Methods:

  • Prospective, multi-site observational study.
  • Followed 105 patients (19 female, 86 male) aged 60.6±9.8 years with advanced CHF (NYHA class 3.2±0.4).
  • Investigated mortality and mode of death in patients with coronary artery disease (54%) and non-coronary heart failure (46%).

Main Results:

  • 21% of patients died within the follow-up period (mean 730 days).
  • Sudden cardiac deaths (SCD) constituted 24% of all deaths, predominantly within the first year.
  • Heart failure deaths (HFD) accounted for 62% of mortality, with risk increasing after the first year.

Conclusions:

  • The highest risk of sudden cardiac death in CRT-P patients occurs within the first year post-implantation.
  • The risk of death from heart failure increases beyond the first year.
  • Prophylactic defibrillation should be considered for all patients eligible for CRT.
Abstract

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