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Long‐Term Follow‐Up of Cardiac Resynchronization Therapy in Patients with End‐Stage Heart Failure
Author(s) -
MOLHOEK SANDER G.,
BAX JEROEN J.,
BLEEKER GABE B.,
HOLMAN EDUARD R.,
VAN ERVEN LIESELOT,
BOOTSMA MARIANNE,
BOERSMA ERIC,
STEENDIJK PAUL,
VAN DER WALL ERNST E.,
SCHALIJ MARTIN J.
Publication year - 2005
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2005.40685.x
Subject(s) - medicine , cardiac resynchronization therapy , heart failure , ejection fraction , cardiology , qrs complex , left bundle branch block , stage (stratigraphy) , quality of life (healthcare) , bundle branch block , cohort , electrocardiography , paleontology , nursing , biology
Cardiac resynchronization therapy (CRT) has been introduced to treat patients with end‐stage heart failure, and results of this technique are promising. The aim of our study was to assess the sustained benefit of CRT in a large patient cohort with end‐stage heart failure at long‐term follow‐up. In addition, the prognosis of responders and nonresponders was evaluated. Methods and Results: 125 patients with end‐stage heart failure, NYHA class III or IV, LVEF <35%, QRS duration >120 msec and left bundle branch block morphology received a biventricular device. At baseline and 6 months after implantation the following parameters were evaluated: NYHA class, Minnesota Quality of life score, QRS duration on surface ECG, 6‐minute walking distance and LVEF. Follow‐up was obtained up to 3 years. After 6 months, patients were divided in clinical responders and nonresponders according to improvement in NYHA class. All clinical parameters improved significantly at 6‐month follow‐up. Hospitalization for heart failure was 3.8 ± 4.9 days/year before and 0.7 ± 1.6 days/year after CRT. Survival at 1‐, 2‐, and 3‐year follow‐up was 93%, 88%, and 85%, respectively. Responders (78%) showed a significantly better survival than nonresponders at 2‐ and 3‐year follow‐up (96% and 93% for responders versus 81% and 73% for nonresponders, P < 0.05). Conclusion: The improvement in functional status and symptoms after CRT is maintained at long‐term follow‐up (up to 3 years). The clinical improvement was associated with a significant reduction in hospitalization rate which was also maintained over the years. Preimplantation selection of responders may result in even better long‐term survival.