P807Baseline characteristics and outcome of the resynchronization therapy in patients with valvular heart disease: single-center experience

Introduction: Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF) in ischemic and non-ischemic cardiomyopathy (NIDCM) with widened QRS interval. However, baseline characteristics and outcome of patients with rheumatismal valvular disease (RVD), congestive heart failure and LBBB who received CRT are poorly known, as they are not isolated within the group of patients with NIDCM. Methods: In this prospective single center study analysis of clinical, electrocardiographic, echocardiographic and outcome data of patients who received CRT in NIDCM and divided in two groups: RVD and non-RVD. Results: From September 2013 to august 2016, nighty eight consecutive patients with NIDM (60 males, mean age 61.5±2.2 years old), admitted in our center for CRT implantation were included in this study. They all had moderate-to-severe heart failure (14 patients in NYHA class II and 84 patients in class III/IV) despite an optimal medical therapy, a left ventricular ejection fraction (LVEF) ≤35% (mean 29%±4) and a LBBB (mean QRS duration 159±4 msec). Group 1 comprised 24 patients (21 males) with RVD and most of them (20/24) underwent valve replacement surgery and group 2, 74 patients without RVD (39 males). Group 1 patients were younger than group 2 patients (51,8±4, 9 vs 59, 8±2, 4 y/o; p=.01), and had a larger QRS duration (174±10 vs 157±4 msec; p=.009). There was no difference in the clinical status between the two groups (24 patients in group1 and 66 patients in group 2 were in class III/IV; p=.29); neither in the mean LVEF (26.7% vs 29, 3%; p=.2), nor in the process of procedures implant and complications. Overall, after a follow up of 6 months, symptoms improved in 80 % of all patients (17/24 patients in group 1 vs 58/74 patients in group 2, passed in class II p=.8), LVEF increased (≥ 35%) in 66% (11/24 patients in group1 vs 41/74 patients in group 2 p=.7). Concerning mortality 4 patients died in each group (p=.3). Conclusions: Patients with RVD and treated with CRT have clearly different baseline characteristics than patients with other etiologies of NIDCM, they are younger and have larger QRS. Implantation of CRT devices can be performed safely with a high procedure success, leading to an improved of clinical status and left ventricular function in these patients with RVD.