Luka Lipar1, Komandoor Srivathsan2, Luis Roberto Scott3. 1. Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, United States. Electronic address: lipar.luka@siol.net. 2. Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, United States. Electronic address: srivathsan.komandoor@mayo.edu. 3. Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, United States. Electronic address: scott.luis@mayo.edu.
Abstract
BACKGROUND: Cardiac resynchronization therapy (CRT) is considered as a standard adjunct therapy in symptomatic patients with congestive heart failure (CHF) who have a prolonged QRS. There is an increasing number of patients who do not receive de novo CRT devices but are upgraded from right ventricular (RV) pacing to biventricular stimulation. We wanted to evaluate the benefit of CRT in patients with chronic RV pacing in comparison to previously non-paced heart failure patients. METHODS: One hundred and sixty-five patients who had their device newly implanted (group I) and 116 who were upgraded from previously implanted RV pacing systems (group II) at Mayo Clinic Hospital were retrospectively analyzed. Clinical and echocardiographic response to CRT was evaluated. Mean follow-up time was 290±250days. RESULTS: Baseline characteristics did not differ between the two groups of patients. Clinical response rate was identical in Groups I and II (65 vs. 65%, respectively; P=0.98) and echocardiographic response rate was similar in both groups of patients (64 vs. 62%; P=0.80). Post-implant QRS increased in group I and was reduced in group II (5 (27.4) vs. -20.0 (33.9) ms; P<0.001). NYHA class improvement (-0.7 (0.6) vs. -0.7 (0.6), P=0.81), LV ejection fraction increase (9.2 (12.9) vs. 8.2 (9.9)%; P=0.55) and LV end-systolic volume reduction (-34.5 (50.7) vs. -25.7 (47.4)%; P=0.28) were comparable in both groups. CONCLUSIONS: Chronically RV-paced patients who receive CRT have similar short-term benefits when compared with patients with new CRT implantations.
BACKGROUND: Cardiac resynchronization therapy (CRT) is considered as a standard adjunct therapy in symptomatic patients with congestive heart failure (CHF) who have a prolonged QRS. There is an increasing number of patients who do not receive de novo CRT devices but are upgraded from right ventricular (RV) pacing to biventricular stimulation. We wanted to evaluate the benefit of CRT in patients with chronic RV pacing in comparison to previously non-paced heart failurepatients. METHODS: One hundred and sixty-five patients who had their device newly implanted (group I) and 116 who were upgraded from previously implanted RV pacing systems (group II) at Mayo Clinic Hospital were retrospectively analyzed. Clinical and echocardiographic response to CRT was evaluated. Mean follow-up time was 290±250days. RESULTS: Baseline characteristics did not differ between the two groups of patients. Clinical response rate was identical in Groups I and II (65 vs. 65%, respectively; P=0.98) and echocardiographic response rate was similar in both groups of patients (64 vs. 62%; P=0.80). Post-implant QRS increased in group I and was reduced in group II (5 (27.4) vs. -20.0 (33.9) ms; P<0.001). NYHA class improvement (-0.7 (0.6) vs. -0.7 (0.6), P=0.81), LV ejection fraction increase (9.2 (12.9) vs. 8.2 (9.9)%; P=0.55) and LV end-systolic volume reduction (-34.5 (50.7) vs. -25.7 (47.4)%; P=0.28) were comparable in both groups. CONCLUSIONS: Chronically RV-paced patients who receive CRT have similar short-term benefits when compared with patients with new CRT implantations.
Authors: Annamaria Kosztin; Mate Vamos; Daniel Aradi; Walter Richard Schwertner; Attila Kovacs; Klaudia Vivien Nagy; Endre Zima; Laszlo Geller; Gabor Zoltan Duray; Valentina Kutyifa; Bela Merkely Journal: Heart Fail Rev Date: 2018-01 Impact factor: 4.214
Authors: Bogdan Beca; John L Sapp; Martin J Gardner; Christopher Gray; Amir AbdelWahab; Ciorsti MacIntyre; Steve Doucette; Ratika Parkash Journal: CJC Open Date: 2019-03-06