A significant reduction in CDI can be achieved with the introduction of a simple ICP with substantial cost savings.

Transvenous implantation of the LV lead is safe and achievable for CRT with high procedural success rates. For the first time we describe the late complications from CRT in different heart failure populations. This group of patients must be kept under surveillance, not only for heart failure events but also for device-related issues. The reasons for higher complication rates in DCM patients require further evaluation.

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Transcatheter Aortic Valve Implantation (TAVI) is a well-described treatment for symptomatic calcific severe aortic stenosis. However, TAVI technology is being increasingly used around the world to treat selected cases of severe aortic regurgitation (AR). One of the main limitations of using TAVI technology for AR is the lack of calcification, which is common in such cases. This makes anchoring of a TAVI prosthesis to the aortic annulus difficult and risks displacement or embolization. However, with the availability of recapturable and repositionable TAVI technologies, these limitations have been overcome to a large extent. This is the first Corevalve Evolut R device that was used in India and the first TAVI to treat AR in India.

Aim and Hypothesis: Despite the proven symptomatic and mortality benefit of cardiac resynchronization therapy (CRT), there is anecdotal evidence it may be pro-arrhythmic in some patients. We aimed to identify if there were significant differences in the incidence of ventricular arrhythmias (VAs) in patients undergoing CRT-D and implantable cardioverter-defibrillators (ICD) implantation for primary prevention indication. We hypothesized that CRT is unlikely to be pro-arrhythmic based on the positive mortality and morbidity data from large randomized trials.Methods and Results: A retrospective analysis of device therapies for VA in a primary prevention device cohort was performed. Patients with ischemic (IHD) and non-ischemic (DCM) cardiomyopathy and ICD or CRT+ICD devices (CRT-D) implanted between 2005 and 2007 without prior history of sustained VA were included for analysis. VA episodes were identified from stored electrograms and defined as sustained (VT/VF) if therapy [anti-tachycardia pacing (ATP) or shocks] was delivered or non-sustained (NSVT) if not. Of a total of 180 patients, 117 (68% male) were in the CRT-D group, 42% IHD, ejection fraction (EF) 24.5 ± 8.2% and mean follow-up 23.9 ± 9.8 months. 63 patients (84% male) were in the ICD group, 60% IHD, EF 27.7 ± 7.2% and mean follow-up 24.6 ± 10.8 months. Overall, there was no significant difference in the incidence of VA (35.0 vs. 38.1%, p = 0.74), sustained VT (21.3 vs. 28.5%, p = 0.36) or NSVT (12.8 vs. 9.5%, p = 0.63) and no significant difference in type of therapy received for VT/VF: ATP (68 vs. 66.6%, p = 0.73) and shocks (32 vs. 33.3%, p = 0.71) between the CRT-D and ICD groups, respectively.Conclusion: In patients with cardiomyopathy receiving CRT-D and ICDs for primary prophylaxis, there was no significant difference in the incidence of VA. From this single center retrospective analysis, there is no evidence to support cardiac resynchronization causing pro-arrhythmia.

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