Abstract:
OBJECTIVES:This study aimed to investigate the effect of both history of intermittent atrial tachyarrhythmias (IAT) and in-trial IAT on the risk of heart failure (HF) or death comparing cardiac resynchronization therapy with defibrillator (CRT-D) to implantable cardioverter-defibrillator (ICD) treatment in mildly symptomatic HF patients with left bundle branch block (LBBB). BACKGROUND:Limited data exist regarding the benefit of CRT-D in patients with IAT. METHODS:The benefit of CRT-D in reducing the risk of HF/death was evaluated using multivariate Cox models incorporating the presence of, respectively, a history of IAT at baseline and time-dependent development of in-trial IAT during follow-up in 1,264 patients with LBBB enrolled in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study. RESULTS:The overall beneficial effect of CRT-D versus ICD on the risk of HF/death was not significantly different between LBBB patients with or without history of IAT (HR: 0.50, p = 0.028, and HR: 0.46, p < 0.001, respectively; p for interaction = 0.79). Among patients who had in-trial IAT, CRT-D was associated with a significant 57% reduction in the risk of HF/death compared with ICD-only therapy (HR: 0.43, p = 0.047), similar to the effect of the device among patients who did not have IAT (HR: 0.47, p < 0.001; p for interaction = 0.85). The percentage of patients with biventricular pacing ≥92% was similar in both groups (p = 0.43). Consistent results were shown for the benefit of CRT-D among patients who had in-trial atrial fibrillation/flutter (HR: 0.30, p = 0.027; p for interaction = 0.41). CONCLUSIONS:In the MADIT-CRT study, the clinical benefit of CRT-D in LBBB patients was not attenuated by prior history of IAT or by the development of in-trial atrial tachyarrhythmias. (MADIT-CRT: Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy; NCT00180271).
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Ruwald AC,Pietrasik G,Goldenberg I,Kutyifa V,Daubert JP,Ruwald MH,Jons C,McNitt S,Wang P,Zareba W,Moss AJdoi
10.1016/j.jacc.2013.10.074subject
Has Abstractpub_date
2014-04-01 00:00:00pages
1190-1197issue
12eissn
0735-1097issn
1558-3597pii
S0735-1097(13)06281-5journal_volume
63pub_type
杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:The pathophysiology of cardiomyopathy associated with premature ventricular contractions (PVCs) remains unclear. OBJECTIVES:This study prospectively explored cardiomyopathy development in a swine model of paced ectopic beats. METHODS:A total of 35 swine underwent pacemaker implantation. A group exposed to ...
journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2009.06.020
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abstract:OBJECTIVES:This study sought to determine the outcome of aortic valve replacement for aortic regurgitation complicated by extreme left ventricular dilation. BACKGROUND:Aortic valve replacement has been recommended in aortic regurgitation with extreme left ventricular dilation (diastolic dimension >/= 80 mm), but extre...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(95)00525-0
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abstract:OBJECTIVES:The purpose of this study was to determine the role of the endothelium in the vascular actions of protease-activated receptor type 1 (PAR-1) activation in vivo in man. BACKGROUND:Thrombin is central to the pathophysiology of atherothrombosis. Its cellular actions are mediated via PAR-1. Protease-activated r...
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doi:10.1016/j.jacc.2007.12.047
更新日期:2008-05-06 00:00:00
abstract::Certain clinical and cardiac morphologic findings are described in 22 patients, aged 45 to 80 years (mean 64) (15 men [68%]), in whom rupture of a papillary muscle occurred during acute myocardial infarction. In most, the acute infarction associated with papillary muscle rupture was a first coronary event (only 18% ha...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(86)80182-6
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abstract:OBJECTIVES:We investigated the safety and efficacy of cryoablation in the treatment of pediatric patients with accessory pathways (APs) located near the atrioventricular junction and with atrioventricular nodal re-entrant tachycardia (AVNRT). BACKGROUND:Few studies concern cryoablation in a significant number of pedia...
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pub_type: 杂志文章
doi:10.1016/j.jacc.2004.12.048
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journal_title:Journal of the American College of Cardiology
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更新日期:2012-10-16 00:00:00
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doi:10.1016/s0735-1097(98)00196-x
更新日期:1998-07-01 00:00:00
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更新日期:2018-03-06 00:00:00
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更新日期:1986-08-01 00:00:00