Implications of ventricular arrhythmia after cardiac resynchronization therapy
Nobuhiko Ueda1, Kohei Ishibashi1, Takashi Noda1
1Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Heart Rhythm
|September 22, 2023
Summary
Ventricular arrhythmia (VA) in cardiac resynchronization therapy (CRT) patients indicates a higher risk of death or heart failure hospitalization. VA is linked to electrical delay and reduced CRT response, suggesting a poor prognosis.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Conflicting data exist on mortality risks associated with ventricular arrhythmia (VA) and shock therapy.
- Cardiac resynchronization therapy (CRT) can reduce VA risk, but its prognostic significance in CRT patients remains unclear.
Purpose of the Study:
- To determine the prognostic value of ventricular arrhythmia (VA) in patients receiving cardiac resynchronization therapy (CRT).
Main Methods:
- A cohort of 330 patients was followed for 1 year post-CRT implantation.
- The primary endpoint was a composite of all-cause mortality or heart failure hospitalization.
Main Results:
- Ventricular arrhythmia (VA) events occurred in 43 patients, who showed a significantly higher risk of the primary endpoint, even among CRT responders (P = .009).
- Fast VA correlated with increased primary endpoint risk (HR 2.14; P = .035), while shock therapy did not (P = .269).
- Patients with VA had lower CRT response rates (53% vs 70%; P = .031) and longer left ventricular paced conduction times (174 ms vs 143 ms; P = .003).
Conclusions:
- Ventricular arrhythmia (VA) occurrence within one year post-CRT is associated with paced electrical delay and diminished CRT response.
- VA may serve as an indicator of poor prognosis in cardiac resynchronization therapy patients.
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