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Vol 14, No 2 (2019)
Original Papers
Published online: 2019-05-22
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Long-term observation in patients with implantable cardioverter-defibrillator with and without resynchronisation therapy

Agnieszka Kołodzińska, Diana Paskudzka, Anna Maria Gawałkiewicz, Marcin Grabowski, Andrzej Cacko, Przemysław Stolarz, Krzysztof Krasuski, Grzegorz Opolski
DOI: 10.5603/FC.2019.0032
·
Folia Cardiologica 2019;14(2):136-141.

open access

Vol 14, No 2 (2019)
Original Papers
Published online: 2019-05-22

Abstract

Introduction. An implantable cardioverter-defibrillator (ICD) with or without resynchronisation therapy (CRT-D) is an effective treatment in heart failure patients (pts.). 

Materials and methods. We retrospectively analysed 60 patients (50/60; 83.33% male) with implanted ICD or CRT-D followed-up in the Cardiology Department between May 1995 and February 2019 who had undergone at least one device exchange. 

Results. Women rarely received ICD, and especially ICD with CRT-D, compared to men [9/26 females in ICD and 1/24 in CRT-D group (p = 0.035) OR 8.31 95% CI (0.98–70.56)] and presented higher left ventricular ejection fraction (LVEF) (38.11 ± 12.74% vs 29.65 ± 12.63, p = 0.027). CRT-D in our patients was implanted mainly as primary prevention [22/25 vs 18/35 (p = 0.0726) OR 6.93 95% CI (1.75–27.43)] and in patients with a lower LVEF compared to the ICD- only patients [24.75 ± 8.98 vs 35.52 ± 13.55% (p = 0.001)]. Technical analysis of endocardial lead parameters at im- plantation and at the final follow-up revealed a decrease in impedance in cases of atrial, defibrillator and left-ventricular leads. In the ICD-only group, atrial impedance was 280.03 ± 335.3 vs 218.29 ± 229.48 ohm (p = 0.0018), and defi- brillator lead impedance was 768.66 ± 210.62 vs 507.03 ± 131.67 ohm (p < 0.001) (at implantation vs final follow-up respectively). In the ICD plus CRT-D group, mean atrial lead impedance was 511.05 ± 271.30 vs 388.55 ± 231.75 ohm (p = 0.007), impedance of the defibrillator lead was 698.95 ± 165.45 vs 547.13 ± 385.24 ohm (p = 0.002), and impe- dance of the left-ventricular lead was 1,036.28 ± 337.34 vs 794.87 ± 274.99 ohm (p < 0.001). 

Conclusion. Women receive CRT-D therapy less often than men. CRT-D is implanted in pts. with lower LVEF and mainly as primary prevention. All endocardial leads impedance decreased with the passing of time. 

Abstract

Introduction. An implantable cardioverter-defibrillator (ICD) with or without resynchronisation therapy (CRT-D) is an effective treatment in heart failure patients (pts.). 

Materials and methods. We retrospectively analysed 60 patients (50/60; 83.33% male) with implanted ICD or CRT-D followed-up in the Cardiology Department between May 1995 and February 2019 who had undergone at least one device exchange. 

Results. Women rarely received ICD, and especially ICD with CRT-D, compared to men [9/26 females in ICD and 1/24 in CRT-D group (p = 0.035) OR 8.31 95% CI (0.98–70.56)] and presented higher left ventricular ejection fraction (LVEF) (38.11 ± 12.74% vs 29.65 ± 12.63, p = 0.027). CRT-D in our patients was implanted mainly as primary prevention [22/25 vs 18/35 (p = 0.0726) OR 6.93 95% CI (1.75–27.43)] and in patients with a lower LVEF compared to the ICD- only patients [24.75 ± 8.98 vs 35.52 ± 13.55% (p = 0.001)]. Technical analysis of endocardial lead parameters at im- plantation and at the final follow-up revealed a decrease in impedance in cases of atrial, defibrillator and left-ventricular leads. In the ICD-only group, atrial impedance was 280.03 ± 335.3 vs 218.29 ± 229.48 ohm (p = 0.0018), and defi- brillator lead impedance was 768.66 ± 210.62 vs 507.03 ± 131.67 ohm (p < 0.001) (at implantation vs final follow-up respectively). In the ICD plus CRT-D group, mean atrial lead impedance was 511.05 ± 271.30 vs 388.55 ± 231.75 ohm (p = 0.007), impedance of the defibrillator lead was 698.95 ± 165.45 vs 547.13 ± 385.24 ohm (p = 0.002), and impe- dance of the left-ventricular lead was 1,036.28 ± 337.34 vs 794.87 ± 274.99 ohm (p < 0.001). 

Conclusion. Women receive CRT-D therapy less often than men. CRT-D is implanted in pts. with lower LVEF and mainly as primary prevention. All endocardial leads impedance decreased with the passing of time. 

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Keywords

resynchronisation therapy; CRT; implantable cardiac defibrillator; ICD; heart failure; impedance lead

About this article
Title

Long-term observation in patients with implantable cardioverter-defibrillator with and without resynchronisation therapy

Journal

Folia Cardiologica

Issue

Vol 14, No 2 (2019)

Pages

136-141

Published online

2019-05-22

DOI

10.5603/FC.2019.0032

Bibliographic record

Folia Cardiologica 2019;14(2):136-141.

Keywords

resynchronisation therapy
CRT
implantable cardiac defibrillator
ICD
heart failure
impedance lead

Authors

Agnieszka Kołodzińska
Diana Paskudzka
Anna Maria Gawałkiewicz
Marcin Grabowski
Andrzej Cacko
Przemysław Stolarz
Krzysztof Krasuski
Grzegorz Opolski

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