Ventricular Arrhythmias in Super-responders to Cardiac Resynchronization Therapy

Arrhythmic Risk Following Recovery of Left Ventricular Ejection Fraction in Patients with Primary Prevention ICD

“…The authors suggested that these patients could be considered for downgrade from CRT‐D to CRT pacemaker (CRT‐P) at the time of battery depletion if no malignant arrhythmias have occurred. Other series have also found that patients with LVEF recovery (a less restrictive definition) are at low arrhythmic risk compared to patients without recovery . Two other studies failed to show a protective effect of LVEF recovery on arrhythmic risk; however, these studies were limited by small sample size .…”

Importance of Implantable Cardioverter‐Defibrillator Back‐Up in Cardiac Resynchronization Therapy Recipients: A Systematic Review and Meta‐Analysis

“…However, it is debatable whether the ICD is of benefit in super‐responders to CRT and those who do not respond to this therapy. While the former may have significantly lower mortality rates and lower risk of ventricular arrhythmias, the latter will have high mortality rates, mostly due to heart failure, and previous studies suggested the ICD has no effect on any mode of death in patients in NYHA class III …”

“…It is known that patients with non-ischemic dilated cardiomyopathy tend to respond better to CRT. As previously discussed, response to CRT predicts a lower risk of all-cause mortality, 44,45 ventricular arrhythmias, [45][46][47][48][49][50] and by inference a lower risk of SCD. The same rationale may help explain the association seen in our meta-regression between male gender and a larger benefit of CRT-D compared with CRT-P. Women are known to respond better to CRT than men and therefore their arrhythmic risk may be lower.…”

Predicting Ventricular Arrhythmias in Cardiac Resynchronization Therapy: The Impact of Persistent Electrical Dyssynchrony

“…Response to cardiac resynchronization therapy (CRT) has been conventionally assessed with the improvement in symptoms and left ventricular (LV) volumes on follow‐up . However, occurrence of ventricular arrhythmias (ventricular tachycardia/ventricular fibrillation [VT/VF]) is of critical importance associated with unfavorable outcomes even in the “superresponders” to CRT . It has been proven that among patients treated with a defibrillator, those who received shock therapy would have a reduced survival rate .…”