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October 28, 2023Journal of Cardiovascular Electrophysiology

Clinical outcomes and predictors of delayed echocardiographic response to cardiac resynchronization therapy

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Key result

Delayed CRT responders match early responder prognosis, though longer HF history and suboptimal leads predict delay.

  • OR 1.126
  • 95% CI 1.036-1.222
  • P=0.005
  • n=110

Why the study?

Clinical outcomes and mechanisms of delayed responses to cardiac resynchronization therapy remained unclear.

Do delayed responders to cardiac resynchronization therapy have similar long-term clinical outcomes compared to early responders?

Population

110 patients who underwent CRT implantation

Comparison

Early response vs delayed response vs non-response

Design

Retrospective study

Follow-up

10.3 ± 0.5 years

Authors

NTNaoki TsurumiYIYasuya IndenSYSatoshi Yanagisawa

Discussion

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Overview

Delayed CRT responders may have comparable long-term outcomes; leaves open whether earlier intervention or lead optimization improves response in prospective studies.

Study Design

Type

Cohort (n=110)

Structured PICO

Do delayed responders to cardiac resynchronization therapy have similar long-term clinical outcomes compared to early responders?

P
Population
110 patients who underwent cardiac resynchronization therapy (CRT) implantation
I
Intervention
Delayed echocardiographic response to cardiac resynchronization therapy (≥15% reduction of left ventricular end-systolic volume at 3 years)
C
Comparator
Early echocardiographic response (at 1 year) and non-response
O
Outcome
Prognosis of mortality and heart failure (HF) hospitalizationhard clinical

Main Result

Effect estimate: OR 1.126 (95% CI 1.036-1.222)

p-value: p=0.005

Patients who exhibit a delayed echocardiographic response to CRT achieve similar long-term survival and freedom from heart failure hospitalization as early responders.

Cite This Study

Tsurumi et al. (2023) conducted a cohort in Heart failure requiring cardiac resynchronization therapy (n=110). Cardiac resynchronization therapy (delayed vs early response) vs. Early response or non-response was evaluated on Predictors of delayed response to CRT compared with early response (longer duration between initial HF hospitalization and CRT) (OR 1.126, 95% CI 1.036-1.222, p=0.005). Delayed and early responders to CRT had similar long-term prognosis, while a longer history of heart failure (OR 1.126; 95% CI 1.036-1.222) and suboptimal LV lead position predicted delayed response.

synapsesocial.com/papers/6a0f037e2eca052da648048bhttps://doi.org/10.1111/jce.16125
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Targeted Left Ventricular Lead Placement to Guide Cardiac Resynchronization Therapy2012 · 654 citations
  2. 2Timing of cardiac resynchronization therapy implantation2023 · 31 citations
  3. 3Effect of QRS Duration and Morphology on Cardiac Resynchronization Therapy Outcomes in Mild Heart Failure2012 · 315 citations
  4. 4Effectiveness of Cardiac Resynchronization Therapy by QRS Morphology in the Multicenter Automatic Defibrillator Implantation Trial–Cardiac Resynchronization Therapy (MADIT-CRT)2011 · 841 citations
  5. 5Repositioning and optimization of left ventricular lead position in nonresponders to cardiac resynchronization therapy is associated with improved ejection fraction, lower NT-proBNP values, and fewer heart failure symptoms2022 · 5 citations