| Reduced atrial tachyarrhythmia susceptibility after upgrade of conventional implanted pulse generator to cardiac resynchronization therapy in patients with heart failure. | |
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MedLine Citation:
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PMID: 17888841 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We sought to identify the impact of cardiac resynchronization therapy (CRT) on atrial tachyarrhythmia (AT) susceptibility in patients with left ventricular (LV) systolic dysfunction in whom worsening heart failure (HF) resulted in upgrade from conventional dual-chamber pulse generator to cardiac resynchronization therapy-defibrillator (CRT-D). BACKGROUND: Cardiac resynchronization therapy with a defibrillator improves survival rates and symptoms in patients with LV systolic dysfunction but little is known about its effects on AT incidence in the same patient population. METHODS: Twenty-eight consecutive HF patients who underwent device upgrade to CRT-D were included. Patients had > or =2 device interrogations in the 1 year before upgrade and > or =3 interrogations in the 18- to 24-month follow-up after upgrade. Echocardiographic parameters were assessed before and at 3 to 6 months after CRT-D. Additional observations included number of hospital stays, HF clinical status, and concomitant pharmacological therapy. By virtue of this study design, each patient served as his/her own control. Statistical analysis was performed by 2-tailed paired t test and with nonparametric tests where appropriate. RESULTS: Within 3 months after CRT, the number of HF patients with documented AT decreased significantly from the immediate pre-CRT value and tended to decline with time. At 1-year follow-up, 90% of patients were AT-free compared with 14% of patients 3 months before CRT (p < 0.001). Furthermore, the number of AT episodes/year and their maximum duration decreased after CRT (mean +/- SD; 181 +/- 50 vs. 50 +/- 20.2, p < 0.05, and 220.8 +/- 87 s vs. 28 +/- 21 s, p < 0.05, respectively). Finally, CRT was associated with improved LV ejection fraction (mean +/- SD; from 26 +/- 5.3% to 31 +/- 7%, p < 0.001) and reduced number of HF or arrhythmia hospital stays (p < 0.05). CONCLUSIONS: Our findings support the view that CRT might decrease AT susceptibility in HF patients with LV systolic dysfunction. |
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Authors:
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Demetris Yannopoulos; Keith G Lurie; Scott Sakaguchi; Simon Milstein; Cengiz Ermis; Laura VanHeel; David G Benditt |
Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2007-09-10 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 50 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-09-24 Completed Date: 2007-10-12 Revised Date: 2008-03-06 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1246-51 Citation Subset: AIM; IM |
Affiliation:
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Cardiac Arrhythmia Center, Department of Medicine, Cardiovascular Division, University of Minnesota Medical School, the University of Minnesota Medical Center-Fairview, Minneapolis, Minnesota, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Defibrillators, Implantable* Female Follow-Up Studies Heart Failure / physiopathology, therapy* Hospitalization / statistics & numerical data Humans Male Stroke Volume / physiology Systole / physiology Tachycardia / physiopathology, prevention & control* Treatment Outcome Ventricular Dysfunction, Left / physiopathology, therapy |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2007 Sep 25;50(13):1252-3
[PMID:
17888842
]
J Am Coll Cardiol. 2008 Feb 12;51(6):676-7; author reply 677 [PMID: 18261690 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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