Ventricular high-rate episodes predict increased mortality in heart failure patients treated with cardiac resynchronization therapy. (February 2015)

• Record Type: Journal Article
• Authors: Jacobsson, Jonatan; Reitan, Christian; Platonov, Pyotr G.; Borgquist, Rasmus
• Is Part Of: Scandinavian cardiovascular journal. Volume 49:Number 1(2015:Feb.)
• Page Start: 20
• Page End: 26
• Publication Date: 2015-02
• Subjects: Cardiovascular system -- Diseases -- Periodicals; 617.41
• DOI: 10.3109/14017431.2015.1006245
• Languages: English
• ISSNs: 1401-7431

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objectives.</italic> Cardiac Resynchronization Therapy (CRT) for heart-failure patients has a well-documented positive effect, but the overall mortality in this group remains high. This study aimed to explore whether additional information from the device post-implant (occurrence of ventricular high-rate episodes), could add prognostic value for patients on CRT-pacemaker (CRT-P) treatment. <italic>Design.</italic> Clinical data and device-interrogation data were retrospectively gathered from the medical records of 220 patients treated with CRT-P. Ventricular high-rate (VHR) episodes were defined as a ventricular rate ≥ 180 beats per minute. The primary outcome was 5-year mortality. <italic>Results.</italic> During follow-up, 132 patients (60%) died or underwent heart transplant. Overall, the 5-year mortality rate was 52%; 77% for patients with VHR during the first year of follow-up and 48% for patients without VHR during the first year of follow-up (<italic>p</italic> = 0.001). In a multivariate model, the occurrence of VHR episodes was an independent predictor of 5-year mortality (HR 9.96, <italic>p</italic> = 0.022). The most common cause of death was heart failure, and death from arrhythmia did not differ between groups (<italic>p</italic> = 0.065). <italic>Conclusions.</italic> In heart-failure patients with CRT-P therapy, occurrence of VHR episodes within the first year post-implant was an independent predictor of higher 5-year mortality and inferior long-term survival, but not of death from malignant arrhythmia.</p> </abstract>