Document Detail

Effect of cardiac resynchronization therapy on the incidence of ventricular arrhythmias in patients with an implantable cardioverter-defibrillator.
MedLine Citation:
PMID:  16188588     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cardiac resynchronization therapy (CRT) reduces mortality in selected patients with heart failure. However, this result may not be entirely related to the beneficial hemodynamic effects of CRT. OBJECTIVES: The purpose of this study was to assess retrospectively the effect of CRT on the incidence of appropriate therapy in patients with an implantable cardioverter-defibrillator (ICD). METHODS: Sixty-five patients (48 men and 17 women; mean age 58 +/- 13 years) with an ICD (31 biventricular, 34 dual-chamber) were included in the study. Clinical, ECG, and ICD stored data and electrograms were collected. RESULTS: Biventricular and dual-chamber ICDs were implanted in 31 and 34 patients, respectively, who had either ischemic (n = 36) or dilated cardiomyopathy (n = 29). Thirty-two (49%) patients received > or =1 appropriate ICD therapy during follow-up of 11 +/- 8 months. Thirty-five percent and 62% of patients with biventricular (n = 11) and dual-chamber ICDs (n = 21), respectively, received appropriate ICD therapy during the follow-up period (odds ratio = 0.340, P = .048). Stratifying the patients according to underlying heart disease and ejection fraction resulted in an adjusted odds ratio = 0.239 (P = .029). Comparing the rate of > or =1 appropriate ICD therapy between the two groups by Kaplan-Meier analysis and the log rank test resulted in P = .027. CONCLUSION: In this retrospective analysis, biventricular pacing was associated with a decreased incidence of sustained ventricular arrhythmias requiring ICD therapy. The antiarrhythmic effect of biventricular pacing could contribute to the reduction in mortality reported in recent large-scale clinical trials on CRT. However, further prospective studies are warranted to clarify this issue.
Arash Arya; Majid Haghjoo; Mohammad Reza Dehghani; Mohammad Alasti; Hormoz Alizadeh; Babak Kazemi; Mohammad Ali Sadr-Ameli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  2     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-28     Completed Date:  2006-02-13     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1094-8     Citation Subset:  IM    
Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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MeSH Terms
Cardiac Pacing, Artificial*
Cardiomyopathy, Dilated / physiopathology,  therapy
Case-Control Studies
Defibrillators, Implantable*
Follow-Up Studies
Middle Aged
Myocardial Ischemia / physiopathology,  therapy
Pacemaker, Artificial
Retrospective Studies
Stroke Volume / physiology
Survival Analysis
Treatment Outcome
Ventricular Fibrillation / physiopathology,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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