Key result
CRT-D reduced the risk of ≥1 ml/kg/min deterioration in VO2max compared to ICD alone in heart failure patients without echocardiographic dyssynchrony (23% vs 68%; HR for ICD 2.4; p=0.005).
Why the study?
Does CRT-D improve peak oxygen consumption, NYHA class, and ejection fraction in heart failure patients with QRS ≥120 ms and LVEF <35% compared to ICD alone, and does echocardiographic dyssynchrony predict this response?
RCT (n=73)
Does CRT-D improve peak oxygen consumption, NYHA class, and ejection fraction in heart failure patients with QRS ≥120 ms and LVEF <35% compared to ICD alone, and does echocardiographic dyssynchrony predict this response?
Hazard Ratio: 2.4 (95% CI 1.2–4.8)
Absolute Event Rate: 23% vs 68%
p-value: p=0.005
Echocardiographic dyssynchrony identifies heart failure patients who derive the most improvement from CRT, though patients without dyssynchrony also benefit more from CRT than ICD alone.
No takes yet. Share an insight, caveat, or question.
Supports CRT-D over ICD alone even without echocardiographic dyssynchrony; extends CRT benefit beyond traditional echo response predictors.
Hunter et al. (2011) conducted an RCT in Heart failure (n=73). Cardiac resynchronisation therapy (CRT-D) vs. Implantable cardioverter defibrillator (ICD) was evaluated on ≥1 ml/kg/min deterioration in VO(2)max at 6 months (HR 2.4, 95% CI 1.2 to 4.8, p=0.005). CRT-D reduced the risk of ≥1 ml/kg/min deterioration in VO2max compared to ICD alone in heart failure patients without echocardiographic dyssynchrony (23% vs 68%; HR for ICD 2.4; p=0.005).
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