Clinical response of cardiac resynchronization therapy in the elderly

Delnoy, Peter Paul H.M.; Ottervanger, Jan Paul; Luttikhuis, Henk Oude; Elvan, Arif; Misier, Anand R. Ramdat; Beukema, Willem P.; Hemel, Norbert M. van

doi:10.1016/j.ahj.2007.11.009

Cited by 46 publications

(31 citation statements)

References 17 publications

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“…Older heart failure patients who undergo cardiac resynchronization therapy derive similar HRQOL benefits as younger patients, for as long as 2 years. 31,32 Older patients with end-stage renal disease who undergo peritoneal dialysis or hemodialysis, also report HRQOL that is better than or similar to younger age groups. [33][34][35] When domains were examined, older dialysis patients were more challenged by physical problems, but mental health was similar to or better than reported by younger patients.…”

Section: Discussionmentioning

confidence: 99%

Change in Health-related Quality of Life from Before to After Destination Therapy Mechanical Circulatory Support is Similar for Older and Younger Patients: Analyses from INTERMACS

Grady

Naftel

Myers

et al. 2014

The Journal of Heart and Lung Transplantation

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Section: Discussionmentioning

confidence: 99%

Change in Health-related Quality of Life from Before to After Destination Therapy Mechanical Circulatory Support is Similar for Older and Younger Patients: Analyses from INTERMACS

Grady

Naftel

Myers

et al. 2014

The Journal of Heart and Lung Transplantation

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“…More recently, with the publication of the REVERSE and MADIT-CRT trials, the indication for initiation of cardiac resynchronization therapy (CRT) has grown to include patients with increasingly less symptomatic heart failure [3,4]. In addition, the benefits of CRT have been realized in older populations with multiple comorbidities that are at higher risk for the development of device-related complications [5]. As a result, the need for CIED extraction has seen a parallel rise.…”

Section: Introductionmentioning

confidence: 98%

Extraction of Implantable Cardiac Electronic Devices

Rickard

Wilkoff

2011

Curr Cardiol Rep

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With the increasing numbers of cardiac implantable devices in use, lead extraction has become a critical procedure in remedying device-related infections and complications. Lead extraction technology has grown considerably over the past two decades from simple traction maneuvers to the use of powered, telescoping sheaths equipped with laser technology. Data from single center experiences and randomized control trials have continued to demonstrate the safety and efficacy of the most current lead extraction technology. Still, major complications occur in less than 1% of patients. Patient preparation and in-place laboratory protocols are important for the prevention of complications and the rapid diagnosis and treatment of life-threatening complications should they arise.

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“…Recent studies have suggested that elderly patients derive similar benefits from CRT to younger patients [8][9][10]. Nevertheless, in these works, the elderly population is quite different in terms of chronological age: Foley et al analyzed a population 80 or more years old; Bleeker et al used 70 as cutoff, and Delnoy et al studied a group older than 75 [8][9][10][11]. In addition, in these studies, there was no reference to comorbidities [8][9][10] or they were present in small rates in these older patients [11].…”

Section: Introductionmentioning

confidence: 99%

Cardiac resynchronization therapy is effective even in elderly patients with comorbidities

António

Lourenço

Teixeira

et al. 2009

J Interv Card Electrophysiol

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Purpose The purpose of this study was to compare the effects of cardiac resynchronization therapy (CRT) in elderly patients (≥65 years) with younger patients and to assess the impact of comorbidities in CRT remodeling response. Methods This is a prospective study of 87 consecutive patients scheduled for CRT who underwent clinical and echocardiographic evaluation before and 6 months after CRT. A reduction in left ventricular end-systolic volume (LVESV) ≥15% after CRT defined remodeling responders, and a reduction of at least one New York Heart Association class defined clinical responders. Multivariate analysis was used to identify independent predictors of non-response to CRT in terms of reverse remodeling. Results The mean age was 62±11 years, with 36 elderly patients (41%). The baseline QRS duration was 145± 32 ms. After CRT, there were significant and similar improvements of left ventricular (LV) ejection fraction, LVESV, LV dP/dt, and mitral regurgitation jet area (JA) between elderly (≥65 years) and younger (<65 years) patients. The number of clinical and remodeling responders was comparable, and we found no significant differences in unplanned cardiac hospitalizations at 6 months between groups. Independent predictors of lack of remodeling response to CRT were QRS duration <120 ms, LV diastolic diameter >74 mm, and JA >10 cm 2 before CRT, but not comorbidities.Conclusion This work suggests that being elderly is not an impediment to CRT success even in the presence of comorbidities.

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Clinical response of cardiac resynchronization therapy in the elderly

Cited by 46 publications

References 17 publications

Change in Health-related Quality of Life from Before to After Destination Therapy Mechanical Circulatory Support is Similar for Older and Younger Patients: Analyses from INTERMACS

Change in Health-related Quality of Life from Before to After Destination Therapy Mechanical Circulatory Support is Similar for Older and Younger Patients: Analyses from INTERMACS

Extraction of Implantable Cardiac Electronic Devices

Cardiac resynchronization therapy is effective even in elderly patients with comorbidities

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