Cecilia M Linde1, Camilla Normand2,3, Nigussie Bogale3, Angelo Auricchio4, Maciej Sterlinski5, Germanas Marinskis6, Christian Sticherling7, Alan Bulava8, Óscar Cano Pérez9, Alexander H Maass10, Klaus K Witte11, Roin Rekvava12, Salima Abdelali13, Kenneth Dickstein2,3. 1. Heart and Vascular Theme, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. 2. Department of Internal Medicine, University of Bergen, Bergen, Norway. 3. Department of Cardiology, Stavanger, Norway. 4. Clinical Electrophysiology Unit, Fondazione Cardiocentro Ticino, Lugano, Switzerland; and University Magdeburg, Germany. 5. Heart Rhythm Department, Institute of Cardiology, Warsaw, Poland. 6. Clinic of Heart Diseases, Vilnius University, Lithuania. 7. University Hospital, Basel, Switzerland. 8. Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic. 9. Unidad de Arritmias, Hospital Universitari I Politècnic La Fe, Valencia, Spain. 10. University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands. 11. University of Leeds, Leeds, UK. 12. Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan. 13. Clinique Belvedere, Rabat, Morocco.
Abstract
BACKGROUND: To date, there are no data from randomized controlled studies on the benefit of cardiac resynchronization therapy (CRT) when implanted as an upgrade in patients with a previous device as compared to de novo CRT. In the CRT Survey II we compared the baseline data of patients upgraded to CRT (CRT-P/CRT-D) from a previous pacemaker (PM) or implantable cardioverter-defibrillator (ICD) to de novo CRT implantation. METHODS AND RESULTS: In the European CRT Survey II, clinical practice data of patients undergoing CRT and/or ICD implantation across 42 European Society of Cardiology (ESC) countries were collected between October 2015 and December 2016. Out of a total of 11 088 patients, 2396 (23.2%) were upgraded from a previous PM or ICD and 7933 (76.8%) underwent de novo implantation. Compared to de novo implantations, upgraded patients were older, more often male, more frequently had ischaemic heart failure aetiology, atrial fibrillation, reduced renal function, worse heart failure symptoms, and higher N-terminal pro-B-type natriuretic peptide levels. Upgraded patients were more often PM-dependent and less frequently received CRT-D. Total peri-procedural, in-hospital complications and length of hospital stay were similar. Upgraded patients were less frequently treated with heart failure medication at discharge. CONCLUSION: Despite a lack of evidenced-based data, close to one quarter of all CRT implantations across 42 ESC countries were upgrades from a previous PM or ICD. Despite older age and worse symptoms, the CRT implantation procedures in upgraded patients were equally frequently successful and complications similar to de novo implantations. These results call for more studies.
BACKGROUND: To date, there are no data from randomized controlled studies on the benefit of cardiac resynchronization therapy (CRT) when implanted as an upgrade in patients with a previous device as compared to de novo CRT. In the CRT Survey II we compared the baseline data of patients upgraded to CRT (CRT-P/CRT-D) from a previous pacemaker (PM) or implantable cardioverter-defibrillator (ICD) to de novo CRT implantation. METHODS AND RESULTS: In the European CRT Survey II, clinical practice data of patients undergoing CRT and/or ICD implantation across 42 European Society of Cardiology (ESC) countries were collected between October 2015 and December 2016. Out of a total of 11 088 patients, 2396 (23.2%) were upgraded from a previous PM or ICD and 7933 (76.8%) underwent de novo implantation. Compared to de novo implantations, upgraded patients were older, more often male, more frequently had ischaemic heart failure aetiology, atrial fibrillation, reduced renal function, worse heart failure symptoms, and higher N-terminal pro-B-type natriuretic peptide levels. Upgraded patients were more often PM-dependent and less frequently received CRT-D. Total peri-procedural, in-hospital complications and length of hospital stay were similar. Upgraded patients were less frequently treated with heart failure medication at discharge. CONCLUSION: Despite a lack of evidenced-based data, close to one quarter of all CRT implantations across 42 ESC countries were upgrades from a previous PM or ICD. Despite older age and worse symptoms, the CRT implantation procedures in upgraded patients were equally frequently successful and complications similar to de novo implantations. These results call for more studies.
Authors: D O Verschure; E Poel; G De Vincentis; V Frantellizzi; K Nakajima; O Gheysens; J R de Groot; H J Verberne Journal: Eur Heart J Cardiovasc Imaging Date: 2021-01-01 Impact factor: 6.875
Authors: Rafal Gardas; Krzysztof S Golba; Tomasz Soral; Jolanta Biernat; Piotr Kulesza; Mateusz Sajdok; Kamil Zub Journal: J Clin Med Date: 2022-09-27 Impact factor: 4.964