Key result
CRT upgrade in pacing-induced cardiomyopathy linked to ~16-point improvement in LVEF.
Why the study?
Recent evidence suggests CRT upgrade may confer benefit in pacing-induced cardiomyopathy, but the extent and predictors of improvement needed assessment.
Does upgrade to cardiac resynchronization therapy improve left ventricular ejection fraction in patients with pacing-induced cardiomyopathy?
Cohort (n=43)
No
Does upgrade to cardiac resynchronization therapy improve left ventricular ejection fraction in patients with pacing-induced cardiomyopathy?
Absolute Event Rate: 44.3% vs 28.7%
p-value: p=<0.001
Upgrading to a CRT device significantly reverses left ventricular systolic dysfunction in patients with pacing-induced cardiomyopathy, leading to substantial structural and symptomatic improvements.
CRT upgrade was associated with LVEF recovery in pacing-induced cardiomyopathy; hypothesis-generating and leaves open randomized confirmation.
Background: Pacing-induced cardiomyopathy (PICM) is an important cause of heart failure in patients with a right ventricular pacing burden. Recent evidence suggests that an upgrade to cardiac resynchronization therapy (CRT) may confer benefit in PICM. Objective: To assess the extent and identify predictors of improvement following upgrade to CRT in patients with PICM. Methods: We retrospectively analyzed 43 patients undergoing CRT upgrade for PICM over the 10-year period of 2011 to 2021 at our center. All patients with PICM who underwent device upgrade from a dual- or single-chamber ventricular pacemaker to CRT were included. PICM was defined as a decrease of ≥10% in left ventricular ejection fraction (LVEF), resulting in an LVEF <50% among patients with ≥20% Right ventricular pacing burden without an alternative cause for cardiomyopathy. Results: .05). We observed a low rate of complications, and 1 in 4 CRT upgrades required venoplasty (n = 10 of 43, 23.3%). Conclusion: We provide further evidence for the benefit of CRT upgrade in the management of patients with PICM.
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Kerley et al. (2023) conducted a cohort in Pacing-induced cardiomyopathy (PICM) (n=43). Upgrade to cardiac resynchronization therapy (CRT) vs. Pre-upgrade baseline was evaluated on Change in left ventricular ejection fraction (LVEF) (p=<0.001). Upgrade to cardiac resynchronization therapy in patients with pacing-induced cardiomyopathy significantly improved mean left ventricular ejection fraction from 28.7% to 44.3% (p<0.001).
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