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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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Real-life data on heart failure before and after implantation of resynchronization and/or defibrillation devices -

Daniel Bonhorst1, Sara Guerreiro2, Cândida Fonseca3

  • 1Instituto Português do Ritmo Cardíaco, Porto Salvo, Portugal.

Revista Portuguesa De Cardiologia
|January 28, 2019
PubMed

Insights

Electronic cardiac devices like ICDs and CRT are used effectively in Portugal for heart failure patients with reduced ejection fraction, showing improved function and lower mortality. This aligns with international guidelines for device implantation.

Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Practice

Background:

  • Heart failure (HF) with reduced left ventricular ejection fraction (LVEF) necessitates advanced treatment strategies.
  • Electronic cardiac devices, including implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT), are crucial for managing HF patients.
  • Understanding current clinical practices in device implantation is vital for optimizing patient outcomes.

Purpose of the Study:

  • To document and analyze the clinical practice in Portugal concerning the utilization of electronic cardiac devices in patients diagnosed with heart failure (HF) and reduced left ventricular ejection fraction (LVEF).

Main Methods:

  • The Síncrone study was a prospective, observational, multicenter registry conducted across 16 Portuguese centers from 2006 to 2014.
  • Included were adult patients with HF, LVEF <35%, and an indication for ICD and/or CRT devices, adhering to European Society of Cardiology guidelines.
  • Patients were followed for one year, with clinical practice dictated by each participating center.

Main Results:

  • A total of 486 patients were enrolled, with half receiving ICDs and the other half CRT pacemakers (CRT-P) or CRT defibrillators (CRT-D).
  • The overall one-year mortality rate was 3.6%, with a 11% hospitalization rate. CRT-P/CRT-D patients had higher hospitalization rates (17%) compared to ICD patients (5.6%).
  • Patients receiving CRT-P/CRT-D demonstrated significant QRS duration reduction and improvements in New York Heart Association functional class.

Conclusions:

  • The Síncrone study confirms that the implantation of electronic cardiac devices in Portugal for HF with reduced LVEF aligns with international recommendations.
  • Patients treated with these devices experienced notable functional improvements.
  • The study indicates a reduction in one-year mortality among patients receiving these advanced cardiac devices.
Abstract

Keywords:
Dispositivos cardíacos implantáveisFração de ejeção ventricular esquerda diminuídaHeart failureHospitalizationImplantable cardiac devicesInsuficiência cardíacaMortalidadeMortalityReduced left ventricular ejection fractionReinternamentoRessincronizaçãoResynchronization

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