Short-term outcome of cardiac resynchronization therapy - A comparison between newly implanted and chronically right ventricle-paced patients

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Abstract

Background Cardiac resynchronization therapy (CRT) is considered as a standard adjunct therapy in symptomatic patients with congestive heart failure (CHF) who have a prolonged QRS. There is an increasing number of patients who do not receive de novo CRT devices but are upgraded from right ventricular (RV) pacing to biventricular stimulation. We wanted to evaluate the benefit of CRT in patients with chronic RV pacing in comparison to previously non-paced heart failure patients. Methods One hundred and sixty-five patients who had their device newly implanted (group I) and 116 who were upgraded from previously implanted RV pacing systems (group II) at Mayo Clinic Hospital were retrospectively analyzed. Clinical and echocardiographic response to CRT was evaluated. Mean follow-up time was 290 ± 250 days. Results Baseline characteristics did not differ between the two groups of patients. Clinical response rate was identical in Groups I and II (65 vs. 65%, respectively; P = 0.98) and echocardiographic response rate was similar in both groups of patients (64 vs. 62%; P = 0.80). Post-implant QRS increased in group I and was reduced in group II (5 (27.4) vs. - 20.0 (33.9) ms; P < 0.001). NYHA class improvement (- 0.7 (0.6) vs. - 0.7 (0.6), P = 0.81), LV ejection fraction increase (9.2 (12.9) vs. 8.2 (9.9)%; P = 0.55) and LV end-systolic volume reduction (- 34.5 (50.7) vs. - 25.7 (47.4)%; P = 0.28) were comparable in both groups. Conclusions Chronically RV-paced patients who receive CRT have similar short-term benefits when compared with patients with new CRT implantations.

Original languageEnglish (US)
Pages (from-to)195-199
Number of pages5
JournalInternational Journal of Cardiology
Volume219
DOIs
StatePublished - Sep 15 2016

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Cardiac Resynchronization Therapy
Heart Ventricles
Cardiac Resynchronization Therapy Devices
Heart Failure
Equipment and Supplies

Keywords

  • Cardiac resynchronization therapy
  • Heart failure
  • Right ventricular pacing
  • Upgrading

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

@article{f6af27c1196a4818baf4731bfdca21dd,
title = "Short-term outcome of cardiac resynchronization therapy - A comparison between newly implanted and chronically right ventricle-paced patients",
abstract = "Background Cardiac resynchronization therapy (CRT) is considered as a standard adjunct therapy in symptomatic patients with congestive heart failure (CHF) who have a prolonged QRS. There is an increasing number of patients who do not receive de novo CRT devices but are upgraded from right ventricular (RV) pacing to biventricular stimulation. We wanted to evaluate the benefit of CRT in patients with chronic RV pacing in comparison to previously non-paced heart failure patients. Methods One hundred and sixty-five patients who had their device newly implanted (group I) and 116 who were upgraded from previously implanted RV pacing systems (group II) at Mayo Clinic Hospital were retrospectively analyzed. Clinical and echocardiographic response to CRT was evaluated. Mean follow-up time was 290 ± 250 days. Results Baseline characteristics did not differ between the two groups of patients. Clinical response rate was identical in Groups I and II (65 vs. 65{\%}, respectively; P = 0.98) and echocardiographic response rate was similar in both groups of patients (64 vs. 62{\%}; P = 0.80). Post-implant QRS increased in group I and was reduced in group II (5 (27.4) vs. - 20.0 (33.9) ms; P < 0.001). NYHA class improvement (- 0.7 (0.6) vs. - 0.7 (0.6), P = 0.81), LV ejection fraction increase (9.2 (12.9) vs. 8.2 (9.9){\%}; P = 0.55) and LV end-systolic volume reduction (- 34.5 (50.7) vs. - 25.7 (47.4){\%}; P = 0.28) were comparable in both groups. Conclusions Chronically RV-paced patients who receive CRT have similar short-term benefits when compared with patients with new CRT implantations.",
keywords = "Cardiac resynchronization therapy, Heart failure, Right ventricular pacing, Upgrading",
author = "Luka Lipar and Komandoor Srivathsan and Luis Scott",
year = "2016",
month = "9",
day = "15",
doi = "10.1016/j.ijcard.2016.06.054",
language = "English (US)",
volume = "219",
pages = "195--199",
journal = "International Journal of Cardiology",
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TY - JOUR

T1 - Short-term outcome of cardiac resynchronization therapy - A comparison between newly implanted and chronically right ventricle-paced patients

AU - Lipar, Luka

AU - Srivathsan, Komandoor

AU - Scott, Luis

PY - 2016/9/15

Y1 - 2016/9/15

N2 - Background Cardiac resynchronization therapy (CRT) is considered as a standard adjunct therapy in symptomatic patients with congestive heart failure (CHF) who have a prolonged QRS. There is an increasing number of patients who do not receive de novo CRT devices but are upgraded from right ventricular (RV) pacing to biventricular stimulation. We wanted to evaluate the benefit of CRT in patients with chronic RV pacing in comparison to previously non-paced heart failure patients. Methods One hundred and sixty-five patients who had their device newly implanted (group I) and 116 who were upgraded from previously implanted RV pacing systems (group II) at Mayo Clinic Hospital were retrospectively analyzed. Clinical and echocardiographic response to CRT was evaluated. Mean follow-up time was 290 ± 250 days. Results Baseline characteristics did not differ between the two groups of patients. Clinical response rate was identical in Groups I and II (65 vs. 65%, respectively; P = 0.98) and echocardiographic response rate was similar in both groups of patients (64 vs. 62%; P = 0.80). Post-implant QRS increased in group I and was reduced in group II (5 (27.4) vs. - 20.0 (33.9) ms; P < 0.001). NYHA class improvement (- 0.7 (0.6) vs. - 0.7 (0.6), P = 0.81), LV ejection fraction increase (9.2 (12.9) vs. 8.2 (9.9)%; P = 0.55) and LV end-systolic volume reduction (- 34.5 (50.7) vs. - 25.7 (47.4)%; P = 0.28) were comparable in both groups. Conclusions Chronically RV-paced patients who receive CRT have similar short-term benefits when compared with patients with new CRT implantations.

AB - Background Cardiac resynchronization therapy (CRT) is considered as a standard adjunct therapy in symptomatic patients with congestive heart failure (CHF) who have a prolonged QRS. There is an increasing number of patients who do not receive de novo CRT devices but are upgraded from right ventricular (RV) pacing to biventricular stimulation. We wanted to evaluate the benefit of CRT in patients with chronic RV pacing in comparison to previously non-paced heart failure patients. Methods One hundred and sixty-five patients who had their device newly implanted (group I) and 116 who were upgraded from previously implanted RV pacing systems (group II) at Mayo Clinic Hospital were retrospectively analyzed. Clinical and echocardiographic response to CRT was evaluated. Mean follow-up time was 290 ± 250 days. Results Baseline characteristics did not differ between the two groups of patients. Clinical response rate was identical in Groups I and II (65 vs. 65%, respectively; P = 0.98) and echocardiographic response rate was similar in both groups of patients (64 vs. 62%; P = 0.80). Post-implant QRS increased in group I and was reduced in group II (5 (27.4) vs. - 20.0 (33.9) ms; P < 0.001). NYHA class improvement (- 0.7 (0.6) vs. - 0.7 (0.6), P = 0.81), LV ejection fraction increase (9.2 (12.9) vs. 8.2 (9.9)%; P = 0.55) and LV end-systolic volume reduction (- 34.5 (50.7) vs. - 25.7 (47.4)%; P = 0.28) were comparable in both groups. Conclusions Chronically RV-paced patients who receive CRT have similar short-term benefits when compared with patients with new CRT implantations.

KW - Cardiac resynchronization therapy

KW - Heart failure

KW - Right ventricular pacing

KW - Upgrading

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