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Follow-up and characteristics of recipients of cardiac resynchronization therapy with and without defibrillator

Maciej Grymuza1, Agnieszka Katarzyńska-Szymańska1, Lidia Chmielewska-Michalak1, Michał Waśniewski1, Romuald Ochotny1, Maciej Lesiak1, Przemysław Mitkowski1
DOI: 10.33963/KP.a2022.0125
·
Pubmed: 35545837
Affiliations
  1. 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland

open access

Online first
Original article
Published online: 2022-05-11

Abstract

BACKGROUND: Cardiac resynchronization therapy defibrillator (CRT-D) and pacemaker (CRT-P) are treatment options for patients with advanced heart failure and electrical dyssynchrony. Current guidelines provide only factors favouring, not specific recommendations as to implant CRT-D or CRT-P. The aim of this analysis was to compare and contrast populations of CRT-D and CRT-P recipients.

METHODS: Retrospective data were collected from medical records, including 231 patients treated with either CRT-D or CRT-P between 2015 and 2019. Following data were analysed: demographics, co-morbidities, pharmacotherapy, laboratory tests and data related to procedure of implantation. Primary endpoint of the study was all-cause mortality.

RESULTS: A total of 231 patients were included (mean age [standard deviation, SD], 64.1 [12.3] years, 76% male), of these, 13.6% (n = 32) with CRT-P and 86.4% (n = 199) with CRT-D. Mean New York Heart Association (NYHA) class did not differ between the groups: 2.23 (0.9) in CRT-P and 2.35 (0.6) in CRT-D group (P = 0.42). Mean left ventricular ejection fraction was lower in patients eligible for CRT-D: 27.1% vs. 38% (P <0.001). Patients were followed for a median of 29 (interquartile range [IQR], 13–44) months, survival in CRT-P group was 84%, in CRT-D — 82% (P = 0.74). Patients in the CRT-P group were older, more often after atrioventricular node ablation. CRT-P group had tendency towards higher Charlton Comorbidity Index, reaching mean of 4.66 (1.5) points vs. 3.96 (1.5) points in CRT-D (P = 0.06).

CONCLUSIONS: Populations with CRT-P and CRT-D differ in terms of comorbidities; however, they have similar survival. Further studies are required to identify group of patients, who derive a benefit from adding a defibrillator.

Abstract

BACKGROUND: Cardiac resynchronization therapy defibrillator (CRT-D) and pacemaker (CRT-P) are treatment options for patients with advanced heart failure and electrical dyssynchrony. Current guidelines provide only factors favouring, not specific recommendations as to implant CRT-D or CRT-P. The aim of this analysis was to compare and contrast populations of CRT-D and CRT-P recipients.

METHODS: Retrospective data were collected from medical records, including 231 patients treated with either CRT-D or CRT-P between 2015 and 2019. Following data were analysed: demographics, co-morbidities, pharmacotherapy, laboratory tests and data related to procedure of implantation. Primary endpoint of the study was all-cause mortality.

RESULTS: A total of 231 patients were included (mean age [standard deviation, SD], 64.1 [12.3] years, 76% male), of these, 13.6% (n = 32) with CRT-P and 86.4% (n = 199) with CRT-D. Mean New York Heart Association (NYHA) class did not differ between the groups: 2.23 (0.9) in CRT-P and 2.35 (0.6) in CRT-D group (P = 0.42). Mean left ventricular ejection fraction was lower in patients eligible for CRT-D: 27.1% vs. 38% (P <0.001). Patients were followed for a median of 29 (interquartile range [IQR], 13–44) months, survival in CRT-P group was 84%, in CRT-D — 82% (P = 0.74). Patients in the CRT-P group were older, more often after atrioventricular node ablation. CRT-P group had tendency towards higher Charlton Comorbidity Index, reaching mean of 4.66 (1.5) points vs. 3.96 (1.5) points in CRT-D (P = 0.06).

CONCLUSIONS: Populations with CRT-P and CRT-D differ in terms of comorbidities; however, they have similar survival. Further studies are required to identify group of patients, who derive a benefit from adding a defibrillator.

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Keywords

Cardiac resynchronization therapy, outcomes research, population, follow-up

About this article
Title

Follow-up and characteristics of recipients of cardiac resynchronization therapy with and without defibrillator

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2022-05-11

Page views

46

Article views/downloads

15

DOI

10.33963/KP.a2022.0125

Pubmed

35545837

Keywords

Cardiac resynchronization therapy
outcomes research
population
follow-up

Authors

Maciej Grymuza
Agnieszka Katarzyńska-Szymańska
Lidia Chmielewska-Michalak
Michał Waśniewski
Romuald Ochotny
Maciej Lesiak
Przemysław Mitkowski

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