Mid-term outcomes in patients implanted with cardiac resynchronization therapy
Sung Ho Lee1, Seung-Jung Park2, June Soo Kim2
1Division of Cardiology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Cardiac resynchronization therapy (CRT) significantly improved heart failure symptoms and echocardiographic measures in Korean patients. CRT reduced heart failure hospitalizations and mortality, demonstrating its effectiveness in managing advanced heart failure.
Area of Science:
- Cardiology
- Medical Devices
Background:
- Heart failure (HF) management often involves addressing cardiac dyssynchrony.
- Cardiac resynchronization therapy (CRT) is a treatment option for selected HF patients.
Purpose of the Study:
- To evaluate the clinical outcomes and echocardiographic changes in Korean patients with heart failure who received CRT.
- To assess the impact of CRT on morbidity, mortality, and heart failure hospitalizations.
Main Methods:
- A retrospective study of 47 patients with implanted CRT in Korea (October 2005 - May 2013).
- Primary endpoint: combined incidence of heart failure hospitalization, heart transplantation, or death.
- Echocardiographic parameters and New York Heart Association (NYHA) classification were assessed pre- and post-CRT.
Main Results:
- The primary composite endpoint occurred in 21.3% of patients over a median follow-up of 17.5 months.
- CRT demonstrated significant improvements in NYHA class, QRS duration, left ventricular volumes, and ejection fraction at 6 months.
- One-year and three-year freedom rates from heart failure hospitalization were 90.1% and 69.4%, respectively.
Conclusions:
- CRT effectively improved symptoms and cardiac function in desynchronized heart failure patients.
- CRT was associated with low mortality and reduced heart failure hospitalizations in this Korean cohort.
Abstract:
We applied cardiac resynchronization therapy (CRT) for desynchronized heart failure patients. We evaluated clinical outcomes including morbidity, mortality, and echocardiographic parameters in 47 patients with implanted CRT in Korea from October 2005 to May 2013. The combined outcomes of hospitalization from heart failure, heart transplantation and death were the primary end point. Median follow-up period was 17.5 months. The primary outcomes listed above occurred in 10 (21.3%) patients. Two patients (4.3%) died after CRT and 8 (17%) patients were hospitalized for recurrent heart failure. Among patients hospitalized for heart failure, 2 (4.3%) patients underwent heart transplantation. The overall free rate of heart failure requiring hospitalization was 90.1% (95% CI, 0.81-0.99) over one year and 69.4% (95% CI, 0.47-0.91) over 3 yr. We observed improvement of the New York Heart Association classification (3.1±0.5 to 1.7±0.4), decreases in QRS duration (169.1 to 146.9 ms), decreases in left ventricular (LV) end-diastolic (255.0 to 220.1 mL) and end-systolic (194.4 to 159.4 mL) volume and increases in LV ejection fraction (22.5% to 31.1%) at 6 months after CRT. CRT improved symptoms and echocardiographic parameters in a relatively short period, resulting in low mortality and a decrease in hospitalization due to heart failure.
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