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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

Cardiac resynchronization and quality of life in patients with minimally symptomatic heart failure

Peter J Veazie1, Katia Noyes, Qinghua Li

  • 1Department of Community and Preventive Medicine, University of Rochester Medical Center, Rochester, NY, USA. peter_veazie@urmc.rochester.edu

Journal of the American College of Cardiology
|October 16, 2012
PubMed

Insights

Cardiac resynchronization therapy with an implantable cardioverter-defibrillator (CRT-ICD) significantly improves quality of life (QOL) in heart failure patients, especially those with left bundle branch block. This CRT-ICD benefit was observed compared to ICD-only therapy.

Area of Science:

  • Cardiology
  • Medical Devices
  • Quality of Life Research

Background:

  • Cardiac resynchronization therapy (CRT) combined with an implantable cardioverter-defibrillator (ICD) reduces heart failure risk in minimally symptomatic patients.
  • The impact of CRT-ICD on the quality of life (QOL) in these patients remains under investigation.

Purpose of the Study:

  • To compare the QOL of patients receiving CRT with an ICD (CRT-ICD) versus those receiving an ICD only.
  • To assess the effectiveness of CRT-ICD in improving patient-reported outcomes.

Main Methods:

  • Utilized data from the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT) involving 1,820 patients.
  • Assessed QOL using the Kansas City Cardiomyopathy Questionnaire (KCCQ) in 1,699 patients with baseline and follow-up measures.
  • Analyzed six KCCQ dimensions and three summary scores, including physical limitation, symptom burden, and overall summary scores.

Main Results:

  • Patients with CRT-ICD demonstrated significantly greater improvements in all KCCQ measures compared to the ICD-only group over an average follow-up of 2.4 years (p < 0.05).
  • This QOL improvement was particularly significant in patients with left bundle branch block (p < 0.01).
  • No significant QOL difference was observed in patients without left bundle branch block.

Conclusions:

  • CRT-ICD therapy is associated with enhanced QOL in relatively asymptomatic heart failure patients compared to ICD-only therapy.
  • The benefit of CRT-ICD on QOL is most pronounced in patients presenting with left bundle branch conduction disturbance.
Abstract

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