Indication and Long-Term Follow-up Results of Cardiac Resynchronization Therapy for Advanced Heart Failure

2005 ◽  
Vol 11 (9) ◽  
pp. S259
Author(s):  
Naoki Matsuda ◽  
Morio Shoda ◽  
Azusa Furugen ◽  
Gohei Tanizaki ◽  
Naoko Ishizuka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Advanced Heart Failure ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Long Term Follow Up

Long-Term Follow-Up of Cardiac Resynchronization Therapy in Patients with End-Stage Heart Failure

2005 ◽  
Vol 16 (7) ◽  
pp. 701-707 ◽  
Author(s):  
SANDER G. MOLHOEK ◽  
JEROEN J. BAX ◽  
GABE B. BLEEKER ◽  
EDUARD R. HOLMAN ◽  
LIESELOT VAN ERVEN ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Long Term Follow Up ◽  
End Stage Heart Failure ◽  
End Stage

Abstract 13267: Age-Related Long-Term Benefit of Cardiac Resynchronization Therapy in LBBB Patients - a MADIT-CRT Long-Term Follow-Up Substudy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sabu Thomas ◽  
Arthur J Moss ◽  
Wojciech Zareba ◽  
Scott McNitt ◽  
Alon Barsheshet ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Age Groups ◽  
Cardiac Resynchronization ◽  
Age Group ◽  
Resynchronization Therapy ◽  
All Cause Mortality ◽  
Long Term Follow Up

Background: Among patients with heart failure (HF), cardiac resynchronization therapy (CRT) combined with a defibrillator (CRT-D) reduces HF events and mortality compared with a defibrillator (ICD) alone. Whether these benefits extend to all age-groups during long-term follow-up is unclear. Hypothesis: We hypothesized that CRT-D would benefit all age groups with respect to reductions in HF events and all-cause mortality. Methods: We assessed the effect of age on HF events and death among patients in the MADIT-CRT long-term follow up study. 1281 patients with class I or II heart failure and left-bundle branch block (LBBB) were randomized to CRT-D or ICD alone. Patients were divided into 3 age groups: <60, 60-74 or ≥75 years and evaluated over 7 years for mortality and HF events. We compared cumulative events using the log-rank test and adjustments were made using a multivariate logistic regression model with various pre-specified covariates. Results: Overall 761 patients received CRT-D and 520 received ICD alone. The median age was 65 years. Among the three age groups, <60, 60-74 and ≥75 there were 399, 651 and 231 patients respectively. Multivariate analysis (Table) revealed that CRT-D compared to ICD alone significantly reduced the composite outcome of HF or death across all age groups: <60 years relative risk reduction (RRR)=39%, p=0.0236; 60-74 years RRR=59%, p<0.001; ≥75 years RRR=55%, p<0.001. CRT-D also significantly reduced HF events in all age groups <60 years RRR=52%, p=0.003; 60-74 years RRR=61%, p<0.001; ≥75 years RRR=73%, p<0.001. CRT-D was associated with significant mortality reduction only in the 60-74 year age group RRR 58%, p<0.001. Conclusion: Among patients with asymptomatic or mild heart failure, reduced LVEF and LBBB, CRT-D results in significant reduction of HF events and in the composite of all-cause mortality and HF events during long-term follow-up. All-cause mortality was significantly reduced with CRT-D only in the 60-74 year age group.

Long-term follow-up of cardiac resynchronization therapy patients with non-ischemic dilated cardiomyopathy assessed by radionuclide angiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Valzania ◽  
R Bonfiglioli ◽  
F Fallani ◽  
J Frisoni ◽  
M Biffi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Radionuclide Angiography ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Long Term Follow Up ◽  
Non Ischemic Dilated Cardiomyopathy ◽  
Lv Ejection Fraction

Abstract Background While the beneficial effects of cardiac resynchronization therapy (CRT) have been widely investigated soon after CRT implantation, relatively few data are available on long-term clinical outcomes of CRT recipients. Aim To investigate long-term outcomes of CRT patients with non-ischemic dilated cardiomyopathy stratified as responders and non-responders according to radionuclide angiography. Methods Consecutive heart failure patients with non-ischemic dilated cardiomyopathy undergoing CRT implantation at our University Hospital between 2007 and 2013 were enrolled. All patients were assessed with equilibrium Tc99 radionuclide angiography at baseline and after 3 months of CRT. Left ventricular (LV) ejection fraction was computed on the basis of relative end-diastolic and end-systolic counts, and intraventricular dyssynchrony was derived by Fourier phase analysis. Response to CRT was defined by an absolute increase in LV ejection fraction (LVEF) ≥5% at 3-month follow-up. Clinical outcome was assessed after 10 years through hospital records review. Results Forty-seven patients (83% men, 63±11 years) were included in the study. At 3 months, 25 (53%) patients were identified as CRT responders according to LVEF increase (from 26±8 to 38±12%, p&lt;0.001). In these patients, LV dyssynchrony decreased from 59±30° to 29±18° (p&lt;0.001). Twenty-two (47%) patients were defined as non-responders. No significant changes in LVEF and LV dyssynchrony (50±30° vs. 38±19°, p=0.07) were observed in non-responders. At long-term follow-up (11±2 years), all-cause and cardiac mortality rates were 24% and 12% in responders vs. 32% and 27% in non-responders, respectively (p=ns). Heart transplantation was performed in 3 patients. One (4%) patient among CRT responders compared with 6 (27%) patients among non-responders died of worsening heart failure (p=0.03). Conclusions Although late overall mortality of non-ischemic CRT recipients was not significantly different between mid-term responders and non-responders, CRT responders were at lower risk of worsening heart failure death. Funding Acknowledgement Type of funding source: None

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