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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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Impact on long-term cardiovascular outcomes of different cardiac resynchronization therapy response criteria

Inês Rodrigues1, Ana Abreu1, Mário Oliveira1

  • 1Cardiology Department, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.

Revista Portuguesa De Cardiologia
|December 15, 2018
PubMed

Insights

Defining response to cardiac resynchronization therapy (CRT) is crucial. Few criteria predict cardiac event-free survival, highlighting the need for standardized definitions in CRT studies.

Area of Science:

  • Cardiology
  • Clinical Trials
  • Heart Failure Management

Background:

  • Cardiac resynchronization therapy (CRT) is a treatment for heart failure.
  • There is a lack of consensus on how to define patient response to CRT.
  • Existing response criteria may not reliably predict clinical outcomes.

Purpose of the Study:

  • To evaluate the predictive value of various CRT response criteria for cardiac event-free survival.
  • To assess the agreement between different CRT response criteria.
  • To identify reliable indicators of CRT success.

Main Methods:

  • Secondary analysis of the BETTER-HF trial data.
  • Eleven different response criteria were applied to patients six months post-CRT.
  • Cox regression and Cohen's kappa were used to assess predictive value and agreement.

Main Results:

  • Only five of eleven criteria predicted event-free survival.
  • Reduced NYHA class (≥1) and increased LVEF (≥15%) were significant predictors.
  • Agreement between response criteria was generally poor.

Conclusions:

  • Many current CRT response criteria lack predictive power for clinical outcomes.
  • Poor agreement among criteria hinders consistent patient assessment.
  • Establishing a consensus definition for CRT response is essential for standardizing research and clinical practice.
Abstract

Keywords:
Cardiac resynchronization therapyCritérios de respostaHeart failureInsuficiência cardíacaPredictors of eventsPreditores de eventosResponse criteriaTerapia de ressincronização cardíaca

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