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What We Can Learn from "Super-responders"

Alessandro Proclemer1, Daniele Muser2, Domenico Facchin1

  • 1University Hospital Santa Maria della Misericordia, Udine 33100, Italy.

Cardiac Electrophysiology Clinics
|November 25, 2015
PubMed

Insights

This review examines cardiac resynchronization therapy (CRT) outcomes, including mortality and defibrillator use, in patients with preserved left ventricular ejection fraction. It considers the need for defibrillator backup in super-responders with normalized heart function.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Cardiac resynchronization therapy (CRT) is a key treatment for heart failure.
  • Patient selection and long-term outcomes, especially in specific subgroups, require ongoing evaluation.

Purpose of the Study:

  • To review current knowledge for decision-making in potential cardiac resynchronization therapy (CRT) recipients.
  • To analyze long-term mortality, sudden death, and CRT-defibrillator interventions.
  • To assess echocardiographic changes in patients with preserved left ventricular ejection fraction (LVEF >50%) post-CRT.

Main Methods:

  • Systematic literature review of studies on CRT outcomes.
  • Analysis of data on mortality, device interventions, and echocardiographic parameters.
  • Consideration of functional status and heart rhythm in response to CRT.

Main Results:

  • Long-term data on total and cardiac mortality, sudden death, and CRT-defibrillator interventions are analyzed.
  • Evolving echocardiographic parameters in patients with LVEF >50% post-CRT are discussed.
  • The impact of normalized left ventricular function in super-responders on defibrillator necessity is evaluated.

Conclusions:

  • Evidence supports informed decision-making for CRT candidacy.
  • Long-term monitoring is crucial, particularly regarding defibrillator backup in super-responders with improved LVEF.
  • Optimizing CRT patient selection and management strategies remains essential.

Keywords:
CRTCardiac resynchronization therapyLeft ventricular ejection fractionLeft ventricular function

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