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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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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

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Mode of Death in Octogenarians Treated With Cardiac Resynchronization Therapy

Pieter Martens1, Frederik H Verbrugge2, Petra Nijst1

  • 1Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Doctoral School for Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.

Journal of Cardiac Failure
|October 9, 2016
PubMed

Insights

Older adults (octogenarians) receiving cardiac resynchronization therapy (CRT) experience significant symptomatic and remodeling benefits, with survival rates comparable to the general age-matched population.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Heart Failure Management

Background:

  • Cardiac resynchronization therapy (CRT) is established for heart failure with reduced ejection fraction (HFrEF) and electrical dyssynchrony.
  • Clinical CRT populations are typically older than those in clinical trials.

Purpose of the Study:

  • To evaluate clinical response, reverse remodeling, outcomes, and causes of death in octogenarians undergoing CRT.
  • Compare octogenarians with younger patients receiving CRT.

Main Methods:

  • Retrospective analysis of 686 CRT patients, including 178 octogenarians.
  • Assessed changes in NYHA class, ejection fraction, and ventricular dimensions.
  • Compared heart failure readmissions, all-cause mortality, and mode of death.
  • Compared octogenarian CRT mortality with age-matched general population data.

Main Results:

  • Octogenarians showed similar improvements in NYHA class, ejection fraction, and ventricular size compared to younger patients.
  • Octogenarians had higher all-cause mortality but similar heart failure readmission rates.
  • Non-cardiac deaths were more prevalent in octogenarians; worsening heart failure was the primary cardiac cause of death.
  • Octogenarians receiving CRT had an annual mortality rate equivalent to the age-matched general population.

Conclusions:

  • Octogenarians benefit significantly from CRT, showing comparable symptomatic and remodeling responses to younger patients.
  • Survival in octogenarians receiving CRT is similar to the general age-matched population.
  • CRT is a viable treatment option for selected octogenarians with HFrEF and dyssynchrony.
Abstract

Keywords:
CRTElderlyheart failure readmissionreverse remodeling

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