open access

Vol 65, No 11 (2007)
Other
Published online: 2007-11-21
Submitted: 2012-12-28
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Original article
Mortality in patients with heart failure treated with cardiac resynchronisation therapy. A long-term multi-centre follow-up study

Maciej Sterliński, Aleksander Maciąg, Oskar Kowalski, Kinga Gościńska-Bis, Mariusz Pytkowski, Ilona Kowalik, Ewa Lewicka-Nowak, Przemysław Mitkowski, Jarosław Kaźmierczak, Zbigniew Kalarus, Włodzimierz Kargul, Andrzej Lubiński, Andrzej Cieśliński, Zdzisława Kornacewicz-Jach, Anna Szwed, Zygmunt Sadowski
Kardiol Pol 2007;65(11):1287-1293.

open access

Vol 65, No 11 (2007)
Other
Published online: 2007-11-21
Submitted: 2012-12-28

Abstract


Background: Benefits of cardiac resynchronisation therapy (CRT) for survival in selected congestive heart failure (CHF) patients have been acknowledged by the 2005 ESC guidelines.
Aim: To analyse mortality in CRT pacing only (CRT-P) patients during at least one-year follow-up.
Methods: This was a prospective, multi-site, at least one-year observational study on mortality and mode of death in patients who received CRT-P due to commonly accepted indications. One-year follow-up data (or earlier death) were available for 105 patients (19 females, 86 males) aged 60.6±9.8 years (35-78). Baseline NYHA class was 3.2±0.4 (3-4). Coronary artery disease (CAD) was the underlying aetiology of CHF in 57 (54%) patients and 48 (46%) patients had CHF due to non-coronary factors.
Results: Mean follow-up duration was 730 days (360-1780), median 625. There were 21 (20%) deaths: 5 (24%) sudden cardiac deaths (SCD), 13 (62%) deaths due to heart failure (HFD) and 3 (14%) other deaths. Thirteen (62%) patients died within the first year of observation. All SCD occurred in this period. Mean time to death was 303±277 days (19-960) to HFD – 339±313 days (19-960) and to SCD – 208±127 days (31-343). There were no significant differences between survivors and non-survivors with respect to left ventricular ejection fraction (LVEF) (25±10 vs. 20±8%), 6-minute walk test (6minWT) (276±166 vs. 285±163 m) and LV diastolic diameter (LVEDD) (71±9 vs. 78±10 mm) (all NS). The SCD and HFD patients had similar age (62.0±5.4 vs. 56.6±13.2 years), gender (80 vs. 83% males), NYHA class (3.1±0.2 vs. 3.5±0.3), LVEF (22±9 vs. 17±5%), LVEDD (86±10 vs. 79±9 mm), 6minWT (270±142 vs. 292±188 m) (NS). In 4 patients from the SCD group CHF was of non-coronary aetiology and only in 1 patient from the HFD group (p=0.003). The values of LVEF, LVEDD and NYHA class in HFD patients who died during the first year after implantation, compared with those who died later, were similar.
Conclusions: Sudden cardiac death probability in the studied CRT-P population was the highest during the first year after implantation. Afterwards, the risk of HFD started to increase. Thus, in all patients eligible for CRT prophylactic defibrillation function should be considered.

Abstract


Background: Benefits of cardiac resynchronisation therapy (CRT) for survival in selected congestive heart failure (CHF) patients have been acknowledged by the 2005 ESC guidelines.
Aim: To analyse mortality in CRT pacing only (CRT-P) patients during at least one-year follow-up.
Methods: This was a prospective, multi-site, at least one-year observational study on mortality and mode of death in patients who received CRT-P due to commonly accepted indications. One-year follow-up data (or earlier death) were available for 105 patients (19 females, 86 males) aged 60.6±9.8 years (35-78). Baseline NYHA class was 3.2±0.4 (3-4). Coronary artery disease (CAD) was the underlying aetiology of CHF in 57 (54%) patients and 48 (46%) patients had CHF due to non-coronary factors.
Results: Mean follow-up duration was 730 days (360-1780), median 625. There were 21 (20%) deaths: 5 (24%) sudden cardiac deaths (SCD), 13 (62%) deaths due to heart failure (HFD) and 3 (14%) other deaths. Thirteen (62%) patients died within the first year of observation. All SCD occurred in this period. Mean time to death was 303±277 days (19-960) to HFD – 339±313 days (19-960) and to SCD – 208±127 days (31-343). There were no significant differences between survivors and non-survivors with respect to left ventricular ejection fraction (LVEF) (25±10 vs. 20±8%), 6-minute walk test (6minWT) (276±166 vs. 285±163 m) and LV diastolic diameter (LVEDD) (71±9 vs. 78±10 mm) (all NS). The SCD and HFD patients had similar age (62.0±5.4 vs. 56.6±13.2 years), gender (80 vs. 83% males), NYHA class (3.1±0.2 vs. 3.5±0.3), LVEF (22±9 vs. 17±5%), LVEDD (86±10 vs. 79±9 mm), 6minWT (270±142 vs. 292±188 m) (NS). In 4 patients from the SCD group CHF was of non-coronary aetiology and only in 1 patient from the HFD group (p=0.003). The values of LVEF, LVEDD and NYHA class in HFD patients who died during the first year after implantation, compared with those who died later, were similar.
Conclusions: Sudden cardiac death probability in the studied CRT-P population was the highest during the first year after implantation. Afterwards, the risk of HFD started to increase. Thus, in all patients eligible for CRT prophylactic defibrillation function should be considered.
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Keywords

cardiac resynchronisation therapy; congestive heart failure; mortality

About this article
Title

Original article
Mortality in patients with heart failure treated with cardiac resynchronisation therapy. A long-term multi-centre follow-up study

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 11 (2007)

Pages

1287-1293

Published online

2007-11-21

Bibliographic record

Kardiol Pol 2007;65(11):1287-1293.

Keywords

cardiac resynchronisation therapy
congestive heart failure
mortality

Authors

Maciej Sterliński
Aleksander Maciąg
Oskar Kowalski
Kinga Gościńska-Bis
Mariusz Pytkowski
Ilona Kowalik
Ewa Lewicka-Nowak
Przemysław Mitkowski
Jarosław Kaźmierczak
Zbigniew Kalarus
Włodzimierz Kargul
Andrzej Lubiński
Andrzej Cieśliński
Zdzisława Kornacewicz-Jach
Anna Szwed
Zygmunt Sadowski

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