Implantable cardioverter-defibrillator and cardiac resynchronization therapy efficacy and safety are altered by pathophysiologic changes in patients with comorbid advanced chronic kidney disease.
Does implantable cardioverter-defibrillator and cardiac resynchronization therapy improve outcomes in patients with comorbid advanced heart failure and advanced chronic kidney disease?
This review highlights the complex interplay between advanced heart failure and advanced chronic kidney disease regarding the efficacy and safety of ICD and CRT devices.
Heart failure and chronic kidney disease are common and clinically important conditions that regularly coexist. Electrophysiologic changes of advanced heart failure often result in abnormal conduction, causing dyssynchronous contraction, and development of ventricular arrhythmias, which can lead to sudden cardiac arrest. In the last 2 decades, implantable cardioverter-defibrillator and cardiac resynchronization therapy devices have been developed to address these complications. However, when the coexisting chronic kidney disease is advanced, the associated pathophysiologic cardiovascular changes can alter the efficacy and safety of those interventions and complicate the management. This review explores the impact of comorbid advanced heart failure and advanced chronic kidney disease on the efficacy and safety of implantable cardioverter-defibrillator and cardiac resynchronization therapy, the currently available evidence, and potential future directions.
“In this episode, Dr. Valentin Fuster discusses a comprehensive review on the challenges and considerations of using implantable cardiography devices in patients with advanced chronic kidney disease and heart failure. Highlighting key findings from Dr. Cecilia Barca's research, he explores the nuanced interplay between these conditions and device efficacy, emphasizing the need for tailored patient evaluations and future studies to improve outcomes.”
Varga et al. (Mon,) conducted a review in Advanced heart failure and advanced chronic kidney disease. Implantable cardioverter-defibrillator and cardiac resynchronization therapy was evaluated. Implantable cardioverter-defibrillator and cardiac resynchronization therapy efficacy and safety are altered by pathophysiologic changes in patients with comorbid advanced chronic kidney disease.