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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

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Predictors of Total Mortality and Echocardiographic Response for Cardiac Resynchronization Therapy: A Cohort Study

Guilherme Ferreira Gazzoni1,2, Matheus Bom Fraga1, Andres Di Leoni Ferrari1

  • 1Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Porto Alegre, RS - Brazil.

Arquivos Brasileiros De Cardiologia
|November 30, 2017
PubMed

Insights

Cardiac resynchronization therapy (CRT) success hinges on patient selection. This study identified age, COPD, and prior heart attack as mortality predictors, while biventricular pacing improved survival and response.

Area of Science:

  • Cardiology
  • Heart Failure Management
  • Medical Device Technology

Background:

  • Up to 40% of patients do not respond to cardiac resynchronization therapy (CRT).
  • Appropriate patient selection is critical for successful CRT in heart failure patients.
  • Understanding mortality predictors and response factors is essential for optimizing CRT outcomes.

Purpose of the Study:

  • To evaluate mortality predictors in patients undergoing CRT in Brazil.
  • To assess factors influencing echocardiographic response to CRT.
  • To identify patient subgroups who benefit most from CRT.

Main Methods:

  • Retrospective cohort study of 170 patients receiving CRT from 2008-2014.
  • Survival analysis using Cox regression and Kaplan-Meier curves.
  • Poisson regression for echocardiographic response predictors.

Main Results:

  • Overall mortality was 30% with independent predictors including age, prior acute myocardial infarction (AMI), and chronic obstructive pulmonary disease (COPD).
  • Higher percentage of biventricular stimulation at 6 months was protective against mortality (HR 0.97, p=0.048).
  • Echocardiographic response was associated with absence of mitral insufficiency, left bundle branch block, and percentage of biventricular stimulation.

Conclusions:

  • Mortality after CRT is independently linked to age, COPD, and previous AMI.
  • Biventricular pacing at 6 months post-implantation is associated with improved survival and echocardiographic response.
  • These findings highlight the importance of patient selection and pacing optimization for CRT efficacy.
Abstract

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