Survival of patients with pacing ‐induced cardiomyopathy upgraded to CRT does not depend on defibrillation therapy

AbstractBackgroundPermanent right ventricular pacing (RVP) results in cardiac dyssynchrony that may lead to heart failure and may be an indication for the use of cardiac resynchronization therapy (CRT). The study aimed to evaluate predictors of outcomes in patients with pacing ‐induced cardiomyopathy (PICM) if upgraded to CRT.Methods115 patients, 75.0 years old (IQR 67.0 –80.0), were upgraded to CRT due to the decline in left ventricle ejection fraction (LVEF) caused by the long‐term RVP. A retrospective analysis was performed using data from hospital and outpatient clinic records and survival data from the national health system.ResultsThe prior percentage of RVP was 100.0% (IQR 97.0 –100.0), with a QRS duration of 180.0ms (IQR 160.0–200.0). LVEF at the time of the upgrade procedure was 27.0% (IQR 21.0‐32.75). The mean follow‐up was 980±522 days. The primary endpoint, death from any cause, was met by 26 (22%) patients. Age>82 years (HR 5.96; 95%CI 2.24 ‐15.89; p = 0.0004) and pre‐CRT implantation LVEF
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: DEVICES Source Type: research

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AbstractBackgroundCardiac resynchronization therapy (CRT) is indicated in patients with medically refractory heart failure and wide QRS duration. While much is known about predictors of left ventricular (LV) remodeling after CRT implantation and short ‐term mortality, limited data exist on long‐term outcomes after CRT placement.MethodsWe retrospectively reviewed all patients undergoing CRT implantation at our center between 2003 and 2008 and examined mortality using institutional electronic records, social security death index, and online obituary search. We included only patients with preimplant echoes with LV ejectio...
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: DEVICE THERAPY Source Type: research
Conclusion In our experience, patients with RV dysfunction less likely benefited from CRT. RV assessment, studied with CMR, appears to be a good predictor of the response to biventricular stimulation.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Heart failure Source Type: research
CONCLUSIONA large proportion of patients are still alive 10 years after CRT implantation. Variables at the time of CRT implant can help provide prognostic information to patients and electrophysiologists to determine the long ‐term benefit and survival of patients after CRT implantation.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: DEVICE THERAPY Source Type: research
Yolanda Benito1, Pablo Martinez-Legazpi1*, Lorenzo Rossini2, Candelas Pérez del Villar1, Raquel Yotti1, Yolanda Martín Peinador3, Daniel Rodríguez-Pérez4, M. Mar Desco4, Constancio Medrano1, Jose Carlos Antoranz4, Francisco Fernández-Avilés1, Juan C. del Álamo2,5 and Javier Bermejo1 1Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERCV, Madrid, Spain 2Department of Mechanical and Aerospace ...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Abstract Some patients with hypertrophic cardiomyopathy (HCM) develop systolic dysfunction, called the dilated phase of HCM (d-HCM), which is associated with increased morbidity and mortality. We conducted a retrospective study using an HCM database to clarify the incidence, clinical characteristics, and long-term outcomes of d-HCM. We analyzed an HCM cohort consisting of 434 patients (273 with apical HCM and 161 with non-apical HCM; 18 had obstructive HCM, 16 had dilated HCM, and 127 had other HCM) diagnosed by echocardiography in our hospital between 1991 and 2010. The follow-up period was 8.4 ± 6.7 years...
Source: The Keio Journal of Medicine - Category: Universities & Medical Training Authors: Tags: Keio J Med Source Type: research
AbstractBackground: Cardiac resynchronization therapy (CRT) is the standard ‐of‐care therapy for the patients with heart failure and left ventricular (LV) dyssynchrony. However, approximately 30% of patients show no response. Recent studies have shown that His bundle pacing (HBP) could be an alternative for the patients with CRT indications. The purpose of this study wa s to evaluate the efficacy of HBP in patients with heart failure.Methods: We searched PubMed and Embase databases for studies evaluating HBP in patients with heart failure and LV dyssynchrony. The successful rate of implantation, QRS duration, pacing th...
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: DEVICES Source Type: research
ing C Abstract AIM: Between October 2015 and December 2016, 11,088 patients from 42 countries having cardiac resynchronisation therapy (CRT) devices implanted were included in the CRT II Survey. We compared the characteristics of Swiss CRT recipients with the overall European population. METHODS: Demographic and procedural data from seven Swiss centres recruiting all consecutive patients undergoing either de-novo CRT implantation or an upgrade to a CRT system were collected and compared with the European population. RESULTS: A total of 320 Swiss patients (24.4% female, mean age 71.0 ± 10.2 years, ...
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
Cardiac resynchronization therapy (CRT) is an established treatment in symptomatic patients with heart failure with a prolonged QRS duration and reduced left ventricular ejection fraction (LVEF) despite optimal medical therapy to improve symptoms and reduce morbidity and mortality [1]. However, approximately one-third of the patients do not benefit from this therapy [2 –4]. Many studies have been published of possible predictors of CRT response, such as age, gender, etiology of cardiomyopathy, atrial fibrillation, QRS duration, QRS morphology, chronic kidney disease, left ventricular end-diastolic volume (LVEDV), LVE...
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
AbstractCardiac resynchronization therapy (CRT) is an important therapeutic tool in the management of patients with heart failure and electrical dyssynchrony. In appropriately selected patients, landmark randomized controlled trials have demonstrated morbidity and mortality benefit beyond standard goal-directed medical therapy. Current guidelines emphasize the greatest clinical efficacy of CRT in patients with symptomatic heart failure, left bundle branch block, and wide QRS duration (>  150 ms). Other relevant considerations include the presence of atrial fibrillation, the presence of AV block, the etiology...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
We present a case of 71-year-old woman with dilated cardiomyopathy, NYHA functional class III and AF. We implanted CRT combined with direct His-bundle pacing. The indication for such a therapy was a left bundle branch block with a QRS complex of 178ms and a left ventricular EF of 15%, left ventricular end-diastolic diameter (LVEDD) of 75mm. After 8months of follow-up the LVEDD was 60mm with EF 35 –40%.
Source: Journal of Electrocardiology - Category: Cardiology Authors: Source Type: research
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