Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia.
<h4>Objectives</h4>The beneficial effects of cardiac resynchronization therapy (CRT) are thought to result from favorable left ventricular (LV) reverse remodeling, however CRT is only successful in about 70% of patients. Whether response to CRT is associated with a decrease in ventricula...
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2012
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oai:doaj.org-article:12e5778a6cd94da08e0a267e312afc792021-11-18T08:09:08ZImprovement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia.1932-620310.1371/journal.pone.0048926https://doaj.org/article/12e5778a6cd94da08e0a267e312afc792012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23152822/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objectives</h4>The beneficial effects of cardiac resynchronization therapy (CRT) are thought to result from favorable left ventricular (LV) reverse remodeling, however CRT is only successful in about 70% of patients. Whether response to CRT is associated with a decrease in ventricular arrhythmias (VA) is still discussed controversially. Therefore, we investigated the incidence of VA in CRT responders in comparison with non-responders.<h4>Methods</h4>In this nonrandomized, two-center, observational study patients with moderate-to-severe heart failure, LV ejection fraction (LVEF) ≤35%, and QRS duration >120 ms undergoing CRT were included. After 6 months patients were classified as CRT responders or non-responders. Incidence of VA was compared between both groups by Kaplan-Meier analysis and Cox regression analysis. ROC analysis was performed to determine the aptitude of LVEF cut-off values to predict VA.<h4>Results</h4>In total 126 consecutive patients (64±11 years; 67%male) were included, 74 were classified as responders and 52 as non-responders. While the mean LVEF at baseline was comparable in both groups (25±7% vs. 24±8%; P = 0.4583) only the responder group showed an improvement of LVEF (36±6% vs. 24±7; p<0.0001) under CRT. In total in 56 patients VA were observed during a mean follow-up of 28±14 months, with CRT responders experiencing fewer VA than non-responders (35% vs. 58%, p<0.0061). Secondary preventive CRT implantation was associated with a higher likelihood of VA. As determined by ROC analysis an increase of LVEF by >7% was found to be a predictor of a significantly lower incidence of VA (AUC = 0.606).<h4>Conclusions</h4>Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia.Christian EickholtMarcus SiekieraKiriakos KirmanoglouAstrid RodenbeckNicole HeussenPatrick SchauerteArtur LichtenbergJan BalzerTienush RassafStefan PeringsMalte KelmDong-In ShinChristian MeyerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 11, p e48926 (2012) |
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Medicine R Science Q Christian Eickholt Marcus Siekiera Kiriakos Kirmanoglou Astrid Rodenbeck Nicole Heussen Patrick Schauerte Artur Lichtenberg Jan Balzer Tienush Rassaf Stefan Perings Malte Kelm Dong-In Shin Christian Meyer Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia. |
| description |
<h4>Objectives</h4>The beneficial effects of cardiac resynchronization therapy (CRT) are thought to result from favorable left ventricular (LV) reverse remodeling, however CRT is only successful in about 70% of patients. Whether response to CRT is associated with a decrease in ventricular arrhythmias (VA) is still discussed controversially. Therefore, we investigated the incidence of VA in CRT responders in comparison with non-responders.<h4>Methods</h4>In this nonrandomized, two-center, observational study patients with moderate-to-severe heart failure, LV ejection fraction (LVEF) ≤35%, and QRS duration >120 ms undergoing CRT were included. After 6 months patients were classified as CRT responders or non-responders. Incidence of VA was compared between both groups by Kaplan-Meier analysis and Cox regression analysis. ROC analysis was performed to determine the aptitude of LVEF cut-off values to predict VA.<h4>Results</h4>In total 126 consecutive patients (64±11 years; 67%male) were included, 74 were classified as responders and 52 as non-responders. While the mean LVEF at baseline was comparable in both groups (25±7% vs. 24±8%; P = 0.4583) only the responder group showed an improvement of LVEF (36±6% vs. 24±7; p<0.0001) under CRT. In total in 56 patients VA were observed during a mean follow-up of 28±14 months, with CRT responders experiencing fewer VA than non-responders (35% vs. 58%, p<0.0061). Secondary preventive CRT implantation was associated with a higher likelihood of VA. As determined by ROC analysis an increase of LVEF by >7% was found to be a predictor of a significantly lower incidence of VA (AUC = 0.606).<h4>Conclusions</h4>Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia. |
| format |
article |
| author |
Christian Eickholt Marcus Siekiera Kiriakos Kirmanoglou Astrid Rodenbeck Nicole Heussen Patrick Schauerte Artur Lichtenberg Jan Balzer Tienush Rassaf Stefan Perings Malte Kelm Dong-In Shin Christian Meyer |
| author_facet |
Christian Eickholt Marcus Siekiera Kiriakos Kirmanoglou Astrid Rodenbeck Nicole Heussen Patrick Schauerte Artur Lichtenberg Jan Balzer Tienush Rassaf Stefan Perings Malte Kelm Dong-In Shin Christian Meyer |
| author_sort |
Christian Eickholt |
| title |
Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia. |
| title_short |
Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia. |
| title_full |
Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia. |
| title_fullStr |
Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia. |
| title_full_unstemmed |
Improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia. |
| title_sort |
improvement of left ventricular function under cardiac resynchronization therapy goes along with a reduced incidence of ventricular arrhythmia. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2012 |
| url |
https://doaj.org/article/12e5778a6cd94da08e0a267e312afc79 |
| work_keys_str_mv |
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