Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años

Background: Multiple randomized trials support the clinical benefits of cardiac resynchronization therapy (CRT) in patients with heart failure (HF) and ventricular dyssynchrony. Since the year 2000 this therapy has been increasingly used in Chile. Aim: To describe the clinical characteristics and fo...

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Autores principales:	Enríquez,Andrés, Barrero,Raúl, Bittner,Alex, Frangini,Patricia, Baeza,Mariana, Millapán,Islandia, González,Rolando, Vergara,Ismael
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2013
Materias:	Cardiac resynchronization therapy Heart failure Mortality
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000800002
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spelling	oai:scielo:S0034-988720130008000022014-01-27Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 añosEnríquez,AndrésBarrero,RaúlBittner,AlexFrangini,PatriciaBaeza,MarianaMillapán,IslandiaGonzález,RolandoVergara,Ismael Cardiac resynchronization therapy Heart failure Mortality Background: Multiple randomized trials support the clinical benefits of cardiac resynchronization therapy (CRT) in patients with heart failure (HF) and ventricular dyssynchrony. Since the year 2000 this therapy has been increasingly used in Chile. Aim: To describe the clinical characteristics and follow-up of HF patients undergoing CRT in a single Chilean university hospital during the last 10 years. Patients and Methods: All patients undergoing CRT between 2000 and 2010 in our university hospital were included. Clinical and echocardiographic data were extracted from medical records and mortality causes were obtained from the National Identification Service. Results: A total of 252 patients underwent CRT during the study period. Seventy five percent were in New York Heart Associatin (NYHA) functional class III and mean ejection fraction was 29 ± 10%. Complete left bundle branch block was present in 55% and 20% had permanent atrial fibrillation (AF). Mean survival was 86% at 1 year and 82% of patients in NYHA class III-IV improved at least one functional class. Survival was poorer in patients with ischemic etiology (hazard ratio (HR) 1.48), functional class IV (HR 2.2), right bundle branch block (RBBB) (HR 3.1) and AF (HR 3.4). No survival differences were observed between patients with and without an implanted cardiodefibrillator. Conclusions: This series show good clinical outcomes, comparable to those reported in randomized trials. Predictors of worse survival included an ischemic etiology, functional class IV, RBBB and AF. Patients with a defibrillator had no better survival, which could be relevant in countries with limited health care resources.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.141 n.8 20132013-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000800002es10.4067/S0034-98872013000800002
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Cardiac resynchronization therapy Heart failure Mortality
spellingShingle	Cardiac resynchronization therapy Heart failure Mortality Enríquez,Andrés Barrero,Raúl Bittner,Alex Frangini,Patricia Baeza,Mariana Millapán,Islandia González,Rolando Vergara,Ismael Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años
description	Background: Multiple randomized trials support the clinical benefits of cardiac resynchronization therapy (CRT) in patients with heart failure (HF) and ventricular dyssynchrony. Since the year 2000 this therapy has been increasingly used in Chile. Aim: To describe the clinical characteristics and follow-up of HF patients undergoing CRT in a single Chilean university hospital during the last 10 years. Patients and Methods: All patients undergoing CRT between 2000 and 2010 in our university hospital were included. Clinical and echocardiographic data were extracted from medical records and mortality causes were obtained from the National Identification Service. Results: A total of 252 patients underwent CRT during the study period. Seventy five percent were in New York Heart Associatin (NYHA) functional class III and mean ejection fraction was 29 ± 10%. Complete left bundle branch block was present in 55% and 20% had permanent atrial fibrillation (AF). Mean survival was 86% at 1 year and 82% of patients in NYHA class III-IV improved at least one functional class. Survival was poorer in patients with ischemic etiology (hazard ratio (HR) 1.48), functional class IV (HR 2.2), right bundle branch block (RBBB) (HR 3.1) and AF (HR 3.4). No survival differences were observed between patients with and without an implanted cardiodefibrillator. Conclusions: This series show good clinical outcomes, comparable to those reported in randomized trials. Predictors of worse survival included an ischemic etiology, functional class IV, RBBB and AF. Patients with a defibrillator had no better survival, which could be relevant in countries with limited health care resources.
author	Enríquez,Andrés Barrero,Raúl Bittner,Alex Frangini,Patricia Baeza,Mariana Millapán,Islandia González,Rolando Vergara,Ismael
author_facet	Enríquez,Andrés Barrero,Raúl Bittner,Alex Frangini,Patricia Baeza,Mariana Millapán,Islandia González,Rolando Vergara,Ismael
author_sort	Enríquez,Andrés
title	Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años
title_short	Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años
title_full	Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años
title_fullStr	Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años
title_full_unstemmed	Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años
title_sort	terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años
publisher	Sociedad Médica de Santiago
publishDate	2013
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000800002
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Terapia de resincronización en pacientes con insuficiencia cardiaca: experiencia acumulada de 10 años

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