Evaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection fraction

Evaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection fraction

Abstract Background The number of patients with chronic heart failure is increasing in Japan. However, the annual number of patients with heart failure who receive cardiac resynchronization therapy (CRT) has been constant in the last few years. In this study, we evaluated patients who did not receiv...

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Autores principales: Makoto Takano, Yui Nakayama, Hisao Matsuda, Tomoo Harada, Yoshihiro J. Akashi
Formato: article
Lenguaje:EN
Publicado: Wiley 2021
Materias:
cardiac resynchronization therapy
guideline
heart failure
implantable cardioverter defibrillator
left bundle branch block
Diseases of the circulatory (Cardiovascular) system
RC666-701
Acceso en línea:https://doaj.org/article/92a1589fb7274f11928c985007170edc
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spelling oai:doaj.org-article:92a1589fb7274f11928c985007170edc2021-12-02T08:25:11ZEvaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection fraction1883-21481880-427610.1002/joa3.12647https://doaj.org/article/92a1589fb7274f11928c985007170edc2021-12-01T00:00:00Zhttps://doi.org/10.1002/joa3.12647https://doaj.org/toc/1880-4276https://doaj.org/toc/1883-2148Abstract Background The number of patients with chronic heart failure is increasing in Japan. However, the annual number of patients with heart failure who receive cardiac resynchronization therapy (CRT) has been constant in the last few years. In this study, we evaluated patients who did not receive CRT despite being eligible for this treatment to elucidate the clinical impact of CRT administration. Methods We assessed 214 patients with a left ventricular ejection fraction (LVEF) ≤ 50% (excluding patients treated with CRT) who underwent transthoracic echocardiography between January and May 2020 at our institution. The patients were stratified into two groups: Group A (n = 26; patients eligible for CRT) and Group B (n = 188; patients ineligible for CRT); however, all patients only received pharmacological therapy. We retrospectively analyzed the prognosis of these patients with respect to the cumulative number of hospitalizations for heart failure and cardiogenic deaths. Results We observed no significant between‐group differences in age, sex, and severity/diagnosis of organic heart disease. Group A had a significantly higher number of hospitalizations for heart failure and cardiogenic deaths than Group B (log‐rank test, P < .01; hazard ratio, 3.05; 95% confidence interval, 1.31‐7.09; average follow‐up period, 675 days). Conclusions This study shows that 12% of patients were eligible for CRT. However, the implantation rate was low and no one was implanted. CRT is underutilized in patients who have heart failure with reduced LVEF. Therefore, we strongly recommend CRT for patients with indications for CRT.Makoto TakanoYui NakayamaHisao MatsudaTomoo HaradaYoshihiro J. AkashiWileyarticlecardiac resynchronization therapyguidelineheart failureimplantable cardioverter defibrillatorleft bundle branch blockDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Arrhythmia, Vol 37, Iss 6, Pp 1532-1536 (2021)
institution DOAJ
collection DOAJ
language EN
topic cardiac resynchronization therapy
guideline
heart failure
implantable cardioverter defibrillator
left bundle branch block
Diseases of the circulatory (Cardiovascular) system
RC666-701
spellingShingle cardiac resynchronization therapy
guideline
heart failure
implantable cardioverter defibrillator
left bundle branch block
Diseases of the circulatory (Cardiovascular) system
RC666-701
Makoto Takano
Yui Nakayama
Hisao Matsuda
Tomoo Harada
Yoshihiro J. Akashi
Evaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection fraction
description Abstract Background The number of patients with chronic heart failure is increasing in Japan. However, the annual number of patients with heart failure who receive cardiac resynchronization therapy (CRT) has been constant in the last few years. In this study, we evaluated patients who did not receive CRT despite being eligible for this treatment to elucidate the clinical impact of CRT administration. Methods We assessed 214 patients with a left ventricular ejection fraction (LVEF) ≤ 50% (excluding patients treated with CRT) who underwent transthoracic echocardiography between January and May 2020 at our institution. The patients were stratified into two groups: Group A (n = 26; patients eligible for CRT) and Group B (n = 188; patients ineligible for CRT); however, all patients only received pharmacological therapy. We retrospectively analyzed the prognosis of these patients with respect to the cumulative number of hospitalizations for heart failure and cardiogenic deaths. Results We observed no significant between‐group differences in age, sex, and severity/diagnosis of organic heart disease. Group A had a significantly higher number of hospitalizations for heart failure and cardiogenic deaths than Group B (log‐rank test, P < .01; hazard ratio, 3.05; 95% confidence interval, 1.31‐7.09; average follow‐up period, 675 days). Conclusions This study shows that 12% of patients were eligible for CRT. However, the implantation rate was low and no one was implanted. CRT is underutilized in patients who have heart failure with reduced LVEF. Therefore, we strongly recommend CRT for patients with indications for CRT.
format article
author Makoto Takano
Yui Nakayama
Hisao Matsuda
Tomoo Harada
Yoshihiro J. Akashi
author_facet Makoto Takano
Yui Nakayama
Hisao Matsuda
Tomoo Harada
Yoshihiro J. Akashi
author_sort Makoto Takano
title Evaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection fraction
title_short Evaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection fraction
title_full Evaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection fraction
title_fullStr Evaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection fraction
title_full_unstemmed Evaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection fraction
title_sort evaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection fraction
publisher Wiley
publishDate 2021
url https://doaj.org/article/92a1589fb7274f11928c985007170edc
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AT tomooharada evaluationofpotentialunderuseofcardiacresynchronizationtherapyforheartfailurewithreducedejectionfraction
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