The Effect of Left Ventricular (LV) Remodeling on Ventricular Arrhythmia in Cardiac Resynchronization Therapy (CRT‐D) Patients (Antiarrhythmic Effect of CRT)

Abstract

Reverse remodeling associated with CRT implantation can result in decreased frequency of ventricular arrhythmias.

Impact of Improved Left Ventricular Systolic Function on the Recurrence of Ventricular Arrhythmia in Heart Failure Patients With an Implantable Cardioverter‐Defibrillator

“…The results indicate a close correlation between LV function improvement and lower risks of appropriate ICD therapy and the composite endpoint of all‐cause mortality or heart transplant in patients with HFrEF who underwent ICD implantation as a secondary prevention. These results are consistent with those of previous studies that reported LV function improvement in association with favorable outcomes after ICD implantation for primary prevention, CRT‐D upgrade, or new CRT‐D implantation …”

Efficacy of Anti-Tachycardia Pacing for Terminating Fast Ventricular Tachycardia in Japanese Implantable Cardioverter Defibrillator Patients

“…According to previous reports, reverse remodeling by CRT was associated with a significant reduction in the risk of subsequent ventricular arrhythmia. [29][30][31] This could be a factor in the different VT/VF incidence rate.…”

Prevalence of ventricular arrhythmias in patients with cardiac resynchronization therapy without back-up ICD

“…19 However, large clinical studies have suggested that CRT-P could contribute by itself to a reduction in mortality by decreasing the incidence of lethal ventricular arrhythmias, 20 supported by the fact that biventricular cardiac pacing produces reverse remodeling with a favorable impact on outcome and can reduce frequency of ventricular arrhythmias. [21][22][23] Concerning reverse remodeling, the process induced by CRT results in both mechanical and electrical stability of the left ventricle, leading to a lower risk of both heart failure (HF) and arrhythmic events; as shown by Barsheshet et al, 24 a favorable [>25% reduction in left ventricular end-systolic volume (LVESV)] echocardiographic response to CRT-D is associated with a significant 55% reduction in the risk of ventricular arrhythmias compared with ICD-only therapy.…”