The FOI method is feasible, further reduces QRS duration, and improves acute hemodynamic response compared to nominal programming of CRT.

AimsThe beneficial effects of CRT in patients with advanced heart failure, wide QRS, and low LVEF have been clearly established. Nevertheless, mortality remains high in some patients. The aims of our study were to identify the predictors of mortality in patients treated with CRT and to design a risk score for mortality.Methods and resultsA cohort of 608 consecutive patients treated with CRT from 2000 to 2011 in our centre was prospectively analysed. Baseline clinical and echocardiography variables were analysed and mortality data were collected. During a mean follow-up of 36.2 ± 29.2 months, 174 patients died: 123/174 (71%) due to cardiovascular causes, 25/174 (14%) non-cardiac causes, and 26/174 (15%) unknown aetiology. In a multivariate analysis the predictors of mortality were NYHA class IV [hazard ratio (HR) 2.54, 95% confidence interval (CI) 1.7–3.7, P < 0.001], glomerular filtration rate (GFR) <60 mL/min/1.73 m2 (HR 1.61, 95% CI 1.14–2.30, P = 0.008), AF (HR 1.67, 95% CI 1.19–2.3, P = 0.01), age ≥70 years (HR 1.44, (95% CI 1.04–2.00, P = 0.02), and LVEF <22% (HR 1.83, 95% CI 1.33–2.52, P ≤ 0.001). The EAARN score (EF, Age, AF, Renal dysfunction, NYHA class IV) summarizes the predictors. Each additional predictor increased the mortality: one predictor, HR 3.28 (95% CI 1.37–7.8, P = 0.008); two, HR 5.23 (95% CI 2.24–12.10, P < 0.001); three, HR 9.63 (95% CI 4.1–22.60, P < 0.001); and four or more, HR 14.38 (95% CI 5.8–35.65, P < 0.001).ConclusionThe predictors of mortality have a significant add-on predictive effect on mortality. The EAARN score could be useful to stratify the prognosis of CRT patients.

Programming sudden onset and stability detection criteria with a sustained rate duration safety net for triggering tachycardia therapy results in appropriate device management in most patients with supraventricular and slow (< 210 beats/min) ventricular tachycardias.