In:
Pacing and Clinical Electrophysiology, Wiley, Vol. 36, No. 8 ( 2013-08), p. 970-977
Kurzfassung:
Earlier studies in patients with reduced left ventricular ejection fraction (LVEF) ≤35% and prolonged QRS showed better survival outcomes with cardiac resynchronization therapy (CRT). Some patients respond dramatically to CRT by improving their LVEF to the normal range and are considered “super‐responders.” Our aim was to determine whether super‐responders survival increases to levels comparable to the general population. We compared the survival of super‐responders to the general population matched for age and sex. Methods Of 909 patients with CRT device implantation between September 1998 and July 2008, 814 patients had pre‐ and post‐CRT echocardiogram. A total of 95 patients with LVEF ≥ 50% following CRT were classified as super‐responders. For 92 super‐responders, who had U.S. Social Security numbers, an age‐ and sex‐matched example was selected from the Social Security Life Tables. An expected survival plot of the matched population was then compared to the actual survival of super‐responders. Results Super‐responders had comparable survival to the age‐sex matched general population (P = 0.53), and Kaplan‐Meier survival analysis in 92 patients showed that super‐responders with CRT pacemakers had similar survival to those with CRT implantable cardioverter defibrillators (P = 0.77). Super‐responders were more likely to be females (54% vs 25%, P 〈 0.001) and less likely to have significant coronary artery disease (62% vs 42%, P 〈 0.001). Conclusions Normalization of LVEF by CRT improves survival to levels comparable to the general population. This observation favors the concept that some CRT candidates have a cardiomyopathy likely generated by the conduction abnormality that is reversible through biventricular pacing.
Materialart:
Online-Ressource
ISSN:
0147-8389
,
1540-8159
DOI:
10.1111/pace.2013.36.issue-8
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2013
ZDB Id:
2037547-5
