Implications of Ventricular Arrhythmia After Cardiac Resynchronization Therapy.
Anti-tachycardia pacing
heart failure
paced conduction delay
shock therapy
ventricular arrhythmia
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
20 Sep 2023
20 Sep 2023
Historique:
received:
28
06
2023
revised:
02
09
2023
accepted:
16
09
2023
medline:
23
9
2023
pubmed:
23
9
2023
entrez:
22
9
2023
Statut:
aheadofprint
Résumé
Conflicting data are available on whether ventricular arrhythmia (VA) or shock therapy increases mortality. Though cardiac resynchronization therapy (CRT) reduces the risk of VA, little is known about the prognostic value of VA among patients with CRT devices. This study aimed to evaluate the implications of VA as a prognostic marker for CRT. We investigated 330 CRT patients within one year after CRT device implantation. The primary endpoint was the composite endpoint of all-cause death or hospitalization for HF. Forty-three patients had VA events. These patients had a significantly higher risk of the primary endpoint, even among CRT responders (p = 0.009). Fast VA compared to slow VA was associated with an increased risk of the primary endpoint (hazard ratio [HR]: 2.14; 95% confidence interval [CI]: 1.06-4.34, p = 0.035). Shock therapy was not associated with a primary endpoint (shock therapy vs. anti-tachycardia pacing, HR: 1.49; 95% CI: 0.73-3.03, p = 0.269). The patients with VA had a lower prevalence of response to CRT (23 [53%] vs. 202 [70%], p = 0.031) and longer LV-paced conduction time (174 ± 23 ms vs. 143 ± 36 ms, p = 0.003) than the patients without VA. VA occurrence within one year was related to paced electrical delay and poor response to CRT. VA could be associated with poor prognosis among CRT patients.
Sections du résumé
BACKGROUND
BACKGROUND
Conflicting data are available on whether ventricular arrhythmia (VA) or shock therapy increases mortality. Though cardiac resynchronization therapy (CRT) reduces the risk of VA, little is known about the prognostic value of VA among patients with CRT devices.
OBJECTIVES
OBJECTIVE
This study aimed to evaluate the implications of VA as a prognostic marker for CRT.
METHODS
METHODS
We investigated 330 CRT patients within one year after CRT device implantation. The primary endpoint was the composite endpoint of all-cause death or hospitalization for HF.
RESULTS
RESULTS
Forty-three patients had VA events. These patients had a significantly higher risk of the primary endpoint, even among CRT responders (p = 0.009). Fast VA compared to slow VA was associated with an increased risk of the primary endpoint (hazard ratio [HR]: 2.14; 95% confidence interval [CI]: 1.06-4.34, p = 0.035). Shock therapy was not associated with a primary endpoint (shock therapy vs. anti-tachycardia pacing, HR: 1.49; 95% CI: 0.73-3.03, p = 0.269). The patients with VA had a lower prevalence of response to CRT (23 [53%] vs. 202 [70%], p = 0.031) and longer LV-paced conduction time (174 ± 23 ms vs. 143 ± 36 ms, p = 0.003) than the patients without VA.
CONCLUSION
CONCLUSIONS
VA occurrence within one year was related to paced electrical delay and poor response to CRT. VA could be associated with poor prognosis among CRT patients.
Identifiants
pubmed: 37739199
pii: S1547-5271(23)02705-4
doi: 10.1016/j.hrthm.2023.09.014
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023. Published by Elsevier Inc.