Long-term outcome of cardiac resynchronization therapy patients in the elderly

Area of Science:

• Cardiology
• Geriatrics
• Medical Devices

Background:

• Heart failure (HF) significantly impacts elderly populations, yet data on their response to device therapies like cardiac resynchronization therapy (CRT) are limited.
• Understanding age-related differences in CRT effectiveness, complications, and outcomes is crucial for optimizing treatment strategies in diverse patient groups.

Purpose of the Study:

• To evaluate age-related differences in the effectiveness of cardiac resynchronization therapy (CRT).
• To assess procedure-related complications and long-term outcomes associated with CRT across different age groups.
• To determine if elderly patients benefit from CRT comparably to younger patients.

Main Methods:

• Retrospective analysis of 2656 patients who underwent CRT implantation between 2000 and 2020.
• Patients were stratified into three age groups: <65, 65-75, and >75 years.
• Primary endpoint: echocardiographic response (increase >15% in left ventricular ejection fraction [LVEF] within 6 months). Secondary endpoint: composite of mortality, heart transplantation, or left ventricular assist device implantation. Complications were also assessed.

Main Results:

• Significant LVEF improvement was observed in all age groups post-CRT implantation (p < 0.01).
• Echocardiographic response rates were similar across the three age groups (64% vs. 62% vs. 56%; p = 0.41).
• Cumulative complication rates were comparable among age groups (27% vs. 28% vs. 24%; p = 0.15), although survival rates were lower in older groups.

Conclusions:

• Cardiac resynchronization therapy (CRT) demonstrates comparable effectiveness and safety in elderly patients to that in younger individuals.
• Patients with appropriate indications for CRT derive long-term benefits irrespective of their age.
• The findings support the use of CRT in older adults with heart failure, aligning with established treatment guidelines.