Key result
Cardiac resynchronization therapy significantly improved clinical symptoms, NYHA functional class, QRS width, ejection fraction, and LV EDD (all p<0.001) in patients with heart failure.
Why the study?
To describe sociodemographic factors, clinical improvements, post-CRT complications, and CRT efficacy in heart failure patients at the National Hospital of Sri Lanka.
Does cardiac resynchronization therapy (CRT) implantation improve clinical symptoms, NYHA class, and echocardiographic parameters in patients with moderate to severe heart failure?
Observational (n=50)
No
Does cardiac resynchronization therapy (CRT) implantation improve clinical symptoms, NYHA class, and echocardiographic parameters in patients with moderate to severe heart failure?
p-value: p=< 0.001
In a Sri Lankan cohort, CRT implantation significantly improved clinical symptoms, NYHA functional class, QRS width, and left ventricular ejection fraction in patients with moderate to severe heart failure.
Background Cardiac resynchronization therapy (CRT) has been a well-established treatment modality for moderate to severe left ventricular systolic dysfunction with left ventricular desynchrony. This is the pioneering study that analyses the cohort who underwent CRT implantation at the National Hospital of Sri Lanka (NHSL) in Colombo from 2005 to 2020. Objectives This study was carried out to describe socio-demographic factors, improvements in clinical outcome (symptoms, electrocardiographic, and echocardiographic features), and post-CRT complications in the study population, as well as to determine the efficacy of CRT in heart failure. Method A retrospective observational study was conducted on all the living patients who had undergone CRT implantation from 2005 to 2020. The data was gathered from all the consented patients who visited the device programming clinic using a physician-administered questionnaire and clinical records. Data was analyzed using SPSS 25, and significant statistics were assessed with the McNemer test, the Student T test, and the Chi-Squared test. Results The study included 50 patients with a mean age of 52.82+/− 11.66 years and female predominance (56%, n = 28). Idiopathic dilated cardiomyopathy (50%, n = 25) was the leading etiological factor, followed by ischemic cardiomyopathy (28%, n = 14). Clinical symptoms have improved significantly with CRT implantation ( p < 0.001). A significant improvement was found in NYHA functional class ( p < 0.001, 95% CI = 0.072 to 0.284), QRS width ( p < 0.001, 95% CI = 0.229 to 0.534), ejection fraction ( p < 0.001, 95% CI = − 16.437 to − 8.504), and LV EDD (p < 0.001, 95% CI = 2.89 to 9.24). Post-CRT complications included lead malfunction (6%, n = 3) and chronic (14%, n = 7), bleeding or hematoma (2%, n = 1), pocket erosion or infection (6%, n = 3), and infective endocarditis (2%, n = 1). Conclusion According to the study, CRT significantly improves both clinical and functional outcomes in patients with moderate to severe heart failure.
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Don et al. (2024) conducted an observational in Heart failure (n=50). Cardiac resynchronization therapy (CRT) was evaluated on Clinical symptoms, NYHA functional class, QRS width, ejection fraction, and LV EDD (p=< 0.001). Cardiac resynchronization therapy significantly improved clinical symptoms, NYHA functional class, QRS width, ejection fraction, and LV EDD (all p<0.001) in patients with heart failure.
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