TITLE

Characteristics and long-term outcome of Characteristics and long-term outcome of resynchronisation therapy: �real world� experience from a single tertiary care centre

AUTHOR(S)
Steffel, Jan; Milosevic, Gligor; H�rlimann, Anja; Krasniqi, Nazmi; Namdar, Mehdi; Ruschitzka, Frank; Luscher, Thomas F.; Duru, Firat; Holzmeister, Johannes; H�rlimann, David
PUB. DATE
November 2011
SOURCE
Heart;Nov2011, Vol. 97 Issue 20, p1668
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background The individual benefit from cardiac resynchronisation therapy (CRT) varies largely among patients. Aims To compare different definitions of echocardiographic super-response to CRT regarding their ability to predict the incidence of adverse events. Methods Three definitions of super-response to CRT were evaluated in 110 consecutive patients with CRT implantation: (1) an absolute increase in ejection fraction of $10%; (2) a decrease in left ventricular end-systolic volume of $30%; and (3) a decrease in left ventricular end-diastolic volume of $20%. The primary endpoint was a combination of time to death, heart transplantation, ventricular assist device implantation and hospitalisation for heart failure. Secondary endpoints included time to first appropriate implantable cardioverter defibrillator (ICD) discharge during follow-up. Results All three definitions of super-response were highly predictive of a reduced risk for reaching the primary combined endpoint (3-year estimators: 64%6 7% vs 82%67% for ejection fraction $10%; 63%68% vs 92%65% for end-systolic volume $30%; and 62%6 8% vs 94%64% for end-diastolic volume $20%; all p<0.001). In all three analyses, super-responders had a significantly shorter time from diagnosis of heart failure until the time point of CRT implantation. However, even super-responders, independent of the definition, did experience appropriate ICD discharges during follow-up. Conclusions All three definitions of super-response are highly predictive for a favourable outcome after CRT. However, even patients with pronounced reverse left ventricular remodelling experience appropriate ICD discharges during follow-up.
ACCESSION #
67613769

 

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