Use and Outcomes of Dual Chamber or Cardiac Resynchronization Therapy Defibrillators Among Older Patients Requiring Ventricular Pacing in the National Cardiovascular Data Registry Implantable Cardioverter Defibrillator Registry
Key result
Among older patients requiring ventricular pacing without a class I CRT indication, CRT-D was associated with lower 1-year mortality compared with DC-ICD (HR 0.70; 95% CI 0.57-0.87; P=0.001).
Why the study?
In patients with reduced LVEF requiring frequent RV pacing, the clinical practice patterns of CRT versus DC device use and associated outcomes were unknown in those without a class I CRT indication.
Does implantation of a CRT-D improve 1-year mortality and heart failure hospitalization compared to a DC-ICD in older patients requiring ventricular pacing who do not have a class I indication for CRT?
Population
3100 Medicare beneficiaries undergoing first-time CRT-D or DC-ICD implantation requiring ventricular pacing without class I CRT indication
Comparison
CRT-D vs DC-ICD implantation
Design
Retrospective cohort study
Follow-up
1-year
Authors
Discussion
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Member takes
Implication
In older patients requiring ventricular pacing without a class I indication for CRT, CRT-D implantation is associated with significantly lower 1-year mortality and heart failure hospitalization compared to DC-ICD.
Study Design
Type
Cohort (n=3,100)
Multicenter
Yes
Structured PICO
Does implantation of a CRT-D improve 1-year mortality and heart failure hospitalization compared to a DC-ICD in older patients requiring ventricular pacing who do not have a class I indication for CRT?
P
Population
3,100 Medicare beneficiaries (mean age 76.3 years, 19.4% female) undergoing first-time implantation of CRT-D or DC-ICD with a bradycardia pacing indication but no class I indication for CRT.
E
Exposure
Implantation of a cardiac resynchronization therapy defibrillator (CRT-D)
C
Comparator
Implantation of a dual chamber implantable cardioverter defibrillator (DC-ICD)
O
Outcome
1-year all-cause mortality and 1-year heart failure hospitalizationhard clinical
Main Result
Hazard Ratio: 0.7 (95% CI 0.57–0.87)
p-value: p=0.001
In older patients requiring ventricular pacing without a class I indication for CRT, CRT-D implantation is associated with significantly lower 1-year mortality and heart failure hospitalization compared to DC-ICD.
Cite This Study
Borne et al. (2021) conducted a cohort in Ventricular bradycardia pacing indication without a class I indication for CRT (n=3,100). Cardiac resynchronization therapy defibrillator (CRT-D) vs. Dual chamber implantable cardioverter defibrillator (DC-ICD) was evaluated on 1-year all-cause mortality (HR 0.70, 95% CI 0.57-0.87, p=0.001). Among older patients requiring ventricular pacing without a class I CRT indication, CRT-D was associated with lower 1-year mortality compared with DC-ICD (HR 0.70; 95% CI 0.57-0.87; P=0.001).