Global constructive work is associated with ventricular arrhythmias after cardiac resynchronization therapy
Hillah Saffi1, Ulrik Winsløw1, Tharsika Sakthivel1
1Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
European Heart Journal. Cardiovascular Imaging
|July 25, 2023
Summary
Lower global constructive work (GCW) levels in patients with cardiac resynchronization therapy defibrillators (CRT-D) significantly increase the risk of ventricular arrhythmias. This finding highlights GCW as a potential biomarker for predicting arrhythmias post-CRT-D implantation.
Area of Science:
- Cardiology
- Biomedical Engineering
- Echocardiography
Background:
- Non-invasive left ventricular (LV) pressure-strain loops offer novel myocardial work quantification.
- Global constructive work (GCW) shows promise in predicting arrhythmias, especially in cardiac resynchronization therapy (CRT) patients.
Purpose of the Study:
- To evaluate the association between the magnitude of GCW and the occurrence of ventricular arrhythmias in patients post-CRT.
- To determine if GCW can serve as a predictive biomarker for arrhythmias in CRT recipients.
Main Methods:
- 162 patients with CRT defibrillators (CRT-D) were assessed using 2D speckle-tracking echocardiography for GCW.
- Primary outcome: composite of appropriate defibrillator therapy and sustained ventricular arrhythmia.
- Median follow-up was 18 months.
Main Results:
- 10% of patients experienced the primary outcome.
- Patients with below-median GCW (<1473 mmHg%) had an 8.14-fold increased risk (univariate) and 4.75-fold increased risk (multivariate) of ventricular arrhythmias.
- Below-median GCW remained an independent predictor after adjustment for eGFR and QRS duration.
Conclusions:
- A below-median GCW level is associated with a significantly higher risk of ventricular arrhythmias in CRT-D patients.
- GCW measurement may aid in risk stratification for arrhythmias in this patient population.
Keywords:
cardiac resynchronization therapy defibrillatordyssynchronyglobal constructive workglobal longitudinal strainspeckle trackingventricular arrhythmiasMore Related Videos
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