Long-term follow-up of cardiac resynchronization therapy in patients with end-stage heart failure
Long-Term Follow-Up of Cardiac Resynchronization Therapy. Introduction: Cardiac resynchronization therapy (CRT) has been introduced to treat patients with end-stage heart failure, and results of this technique are promising. The aim of our study was to assess the sustained benefit of CRT in a large patient cohort with end-stage heart failure at long-term follow-up. In addition, the prognosis of responders and nonresponders was evaluated. Methods and Results: 125 patients with end-stage heart failure, NYHA class III or IV, LVEF <35%, QRS duration >120 msec and left bundle branch block morphology received a biventricular device. At baseline and 6 months after implantation the following parameters were evaluated: NYHA class, Minnesota Quality of life score, QRS duration on surface ECG, 6-minute walking distance and LVEF. Follow-up was obtained up to 3 years. After 6 months, patients were divided in clinical responders and nonresponders according to improvement in NYHA class. All clinical parameters improved significantly at 6-month follow-up. Hospitalization for heart failure was 3.8 ± 4.9 days/year before and 0.7 ± 1.6 days/year after CRT. Survival at 1-, 2-, and 3-year follow-up was 93%, 88%, and 85%, respectively. Responders (78%) showed a significantly better survival than nonresponders at 2- and 3-year follow-up (96% and 93% for responders versus 81% and 73% for nonresponders, P < 0.05). Conclusion: The improvement in functional status and symptoms after CRT is maintained at long-term follow-up (up to 3 years). The clinical improvement was associated with a significant reduction in hospitalization rate which was also maintained over the years. Preimplantation selection of responders may result in even better long-term survival.
|Keywords||Follow-up, Heart failure, Resynchronization therapy|
|Persistent URL||dx.doi.org/10.1111/j.1540-8167.2005.40685.x, hdl.handle.net/1765/65083|
|Journal||Journal of Cardiovascular Electrophysiology|
Molhoek, S.G, Bax, J.J, Bleeker, G.B, Holman, E.R, van Erven, L, Bootsma, M, … Schalij, M.J. (2005). Long-term follow-up of cardiac resynchronization therapy in patients with end-stage heart failure. Journal of Cardiovascular Electrophysiology, 16(7), 701–707. doi:10.1111/j.1540-8167.2005.40685.x