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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

Prevalence of ventricular arrhythmias in patients with cardiac resynchronization therapy without back-up ICD: a

Miriam Bortnik1, Anna Degiovanni, Gabriele Dell'era

  • 1aClinica Cardiologica, AOU Maggiore della Carità, Novara bStruttura di Cardiologia, Ospedale Santo Spirito, Casale Monferrato, Italy.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|July 2, 2013
PubMed

Insights

Cardiac resynchronization therapy without a defibrillator (CRT-P) is safe for selected heart failure patients. However, upgrading to a CRT-D may not fully prevent sudden cardiac death.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Current guidelines recommend cardiac resynchronization therapy (CRT) for heart failure patients.
  • The optimal use of a back-up implantable cardioverter defibrillator (ICD) alongside CRT (CRT-D) remains unclear.
  • This study investigates ventricular arrhythmias in patients receiving CRT without an ICD (CRT-P).

Purpose of the Study:

  • To evaluate the incidence of ventricular arrhythmias in patients treated with CRT-P.
  • To assess the safety and long-term outcomes of CRT-P implantation.
  • To determine if upgrading to CRT-D adequately prevents sudden cardiac death.

Main Methods:

  • Retrospective analysis of 84 patients implanted with CRT-P.
  • Patients had various underlying conditions including coronary artery disease, dilated cardiomyopathy, and valvular disease.
  • Follow-up included clinical assessment and pacemaker data analysis for ventricular arrhythmias.

Main Results:

  • Unsustained ventricular tachyarrhythmias occurred in 13.1% of patients during a mean follow-up of 29 months.
  • Only one patient experienced sustained ventricular tachycardia.
  • Two patients were upgraded to CRT-D; one died suddenly post-upgrade. Overall mortality was 23.8%.

Conclusions:

  • CRT-P is well-tolerated in selected heart failure patients long-term.
  • Upgrading to CRT-D may not be sufficient to prevent sudden cardiac death in all cases.
Abstract

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