The European cardiac resynchronization therapy survey

Dickstein, Kenneth; Bogale, Nigussie; Priori, Silvia G.; Auricchio, Angelo; Cleland, John G.F.; Gitt, Anselm K.; Limbourg, Tobias; Linde, Cecilia; Veldhuisen, Dirk J. van; Brugada, Josep

doi:10.1093/eurheartj/ehp359

Cited by 216 publications

(142 citation statements)

References 24 publications

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“…Despite the paucity of data from randomized control trials in AF populations, recent guidelines support the use of CRT in AF patients, although restricted to a slightly wider QRS duration > 130 ms [30]. A recent European registry suggests that around 20% of patients undergoing CRT are actually in permanent AF, which is in keeping with our findings [31]. Of note, all but one AF patient in this study had QRS > 130 ms. Rate control was satisfactory in our AF cohort, the ventricular delivery rate was high (median 97%, IQR 91-99%), and none of the patients underwent AV nodal ablation.…”

Section: Discussionsupporting

confidence: 85%

Right ventricular dysfunction is a predictor of non-response and clinical outcome following cardiac resynchronization therapy

Alpendurada

Guha

Sharma

et al. 2011

Journal of Cardiovascular Magnetic Resonance

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BackgroundCardiac resynchronization therapy (CRT) is an established treatment in advanced heart failure (HF). However, an important subset does not derive a significant benefit. Despite an established predictive role in HF, the significance of right ventricular (RV) dysfunction in predicting clinical benefit from CRT remains unclear. We investigated the role of RV function, assessed by cardiovascular magnetic resonance (CMR), in predicting response to and major adverse clinical events in HF patients undergoing CRT.MethodsSixty consecutive patients were evaluated with CMR prior to CRT implantation in a tertiary cardiac centre. The primary end-point was a composite of death from any cause or unplanned hospitalization for a major cardiovascular event. The secondary end-point was response to therapy, defined as improvement in left ventricular ejection fraction ≥ 5% on echocardiography at one year.ResultsEighteen patients (30%) met the primary end-point over a median follow-up period of 26 months, and 27 out of 56 patients (48%) were considered responders to CRT. On time-to-event analysis, only atrial fibrillation (HR 2.6, 95% CI 1.02-6.84, p = 0.047) and RV dysfunction, either by a reduced right ventricular ejection fraction-RVEF (HR 0.96, 95% CI 0.94-0.99, p = 0.006) or tricuspid annular plane systolic excursion-TAPSE (HR 0.88, 95% CI, 0.80-0.96, p = 0.006), were significant predictors of adverse events. On logistic regression analysis, preserved RVEF (OR 1.05, 95% CI 1.01-1.09, p = 0.01) and myocardial scar burden (OR 0.90, 95% CI 0.83-0.96, p = 0.004) were the sole independent predictors of response to CRT. Patients with marked RV dysfunction (RVEF < 30%) had a particularly low response rate (18.2%) to CRT.ConclusionsRight ventricular function is an important predictor of both response to CRT and long-term clinical outcome. Routine assessment of the right ventricle should be considered in the evaluation of patients for CRT.

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Section: Discussionsupporting

confidence: 85%

Right ventricular dysfunction is a predictor of non-response and clinical outcome following cardiac resynchronization therapy

Alpendurada

Guha

Sharma

et al. 2011

Journal of Cardiovascular Magnetic Resonance

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“…Some patients do not respond to the therapy, and other potential problems include phrenic stimulation, the absence of an adequate capture threshold, lead dislocations (especially the left ventricular [LV]), and in general, a higher rate of events related to the device compared with patients who receive cardiac defibrillator (ICD) implants without CRT [1][2][3]. To overcome many of these difficulties, new technical advances had been developed in the last few years but despite these developments, the leads cannot be properly positioned in some patients [4], and non-percutaneous surgical implantation is used whenever possible.…”

Section: Introductionmentioning

confidence: 99%

Acute and mid-term outcomes of transvenous implant of a new left ventricular quadripolar lead versus bipolar leads for cardiac resynchronization therapy: Results from a single-center prospective database

Arias

Pachón²,

Puchol³

et al. 2012

Cardiol J

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Background: The purpose of this study was to evaluate the feasibility of the use of a quadripolar left ventricular (LV) lead for cardiac resynchronization therapy and to compare its acute and mid-term outcomes with those obtained with bipolar leads. Cardiac resynchronization exhibits a high incidence of problems involving the LV lead when conventional leads are used, and these problems may be minimized by using multipolar leads.

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“…Así por ejemplo, los estudios con distribución aleatoria han excluido sistemática-mente a pacientes en FA, que en nuestra serie correspondían a 1 de cada 5 sujetos. Esta cifra es comparable a la práctica rutinaria mundial, como lo demuestra el ESC CRT Survey 13 , en que 23% de los pacientes se encontraba en FA. En nuestra serie la presencia de FA se asoció a una menor tasa de respuesta y a un riesgo de mortalidad 3 veces mayor.…”

Section: Discussionunclassified

Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años

et al. 2013

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The European cardiac resynchronization therapy survey

Cited by 216 publications

References 24 publications

Right ventricular dysfunction is a predictor of non-response and clinical outcome following cardiac resynchronization therapy

Right ventricular dysfunction is a predictor of non-response and clinical outcome following cardiac resynchronization therapy

Acute and mid-term outcomes of transvenous implant of a new left ventricular quadripolar lead versus bipolar leads for cardiac resynchronization therapy: Results from a single-center prospective database

Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años

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