Very long term follow-up of cardiac resynchronization therapy: clinical outcome and predictors of mortality.

Abstract:

BACKGROUND:Cardiac resynchronization therapy (CRT) improves symptoms, left ventricular ejection fraction (LVEF) and survival in patients with heart failure and wide QRS, however, long term clinical outcome is unknown. AIMS:To identify predictors of mortality and evaluate the effects of CRT after long term follow-up. METHODS:Consecutive patients treated with CRT between 1997 and 2002 were included. We collected clinical information from patient files. Patients who were still alive underwent echocardiography and clinical evaluation. RESULTS:We included 179 patients (median age 65.5 years, 144 male). Median follow-up for survival was 4.0 years. Mortality at one and five years was 15% and 53%, respectively. Predictors of mortality were, ischaemic heart disease (IHD), higher NYHA class and lower LVEF (<22.5%) at baseline, and no improvement in NYHA class at early follow-up. NYHA class remained stable from early to long term follow-up after a median of 5.1 years. In patients with non-IHD median LVEF increased significantly from early to long term follow-up (39% vs. 50% p=0.007). CONCLUSION:Predictors of mortality in patients with CRT are IHD, lower LVEF and higher NYHA class at baseline, and no symptomatic response to CRT. After 5 years follow-up, clinical effects are sustained, and in patients with non-IHD further improvements in LVEF are observed.

journal_name

Eur J Heart Fail

authors

Kronborg MB,Mortensen PT,Kirkfeldt RE,Nielsen JC

doi

10.1016/j.ejheart.2008.06.013

subject

Has Abstract

pub_date

2008-08-01 00:00:00

pages

796-801

issue

8

eissn

1388-9842

issn

1879-0844

pii

S1388-9842(08)00288-2

journal_volume

10

pub_type

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