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Predictors of response to cardiac resynchronization therapy: A systematic review.

Abstract：

BACKGROUND:Multiple studies have sought to determine variables associated with improved "response" to cardiac resynchronization therapy(CRT). Such variables, however, are often derived from inadequately controlled, single center cohort studies calling external validity into question. We sought to determine predictors of response to CRT-D and CRT-P utilizing the methods of systematic review. METHODS:We searched MEDLINE, Embase®, and the Cochrane Central Register of Controlled Trials (CENTRAL) from January 1, 1995, as this is the date of first article reporting use of CRT through October 20, 2014. Paired investigators independently screened search results to assess eligibility. For inclusion, investigators abstracted data sequentially and assessed risk of bias independently. Investigators graded the strength of evidence as a group. RESULTS:We identified 13,015 unique citations of which 11,897 were excluded during the abstract screen. During the full-text screening, we excluded 1118 citations. 12 studies reported in 15 articles were included in this review. A left bundle branch (LBBB) morphology, non-ischemic cardiomyopathy (NICM), and female gender were generally associated with improved outcomes following CRT-D. Sinus rhythm (as compared to atrial fibrillation) and a wider QRS duration were associated with improved outcomes following CRT-D albeit with a lower strength of evidence. There was insufficient evidence to determine predictors of outcomes in patients undergoing CRT-P. CONCLUSIONS:A native LBBB, NICM, female gender, sinus rhythm, and a wider QRS duration are associated with improved outcomes following CRT-D implant.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Rickard J,Michtalik H,Sharma R,Berger Z,Iyoha E,Green AR,Haq N,Robinson KA

doi

10.1016/j.ijcard.2016.09.078

subject

Has Abstract

pub_date

2016-12-15 00:00:00

pages

345-352

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(16)32504-9

journal_volume

225

pub_type

杂志文章,评审

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