Effects of cardiac resynchronisation therapy in patients with heart failure having a narrow QRS Complex enrolled in PROSPECT

Bommel, Rutger J van; Gorcsan, John; Chung, Eugene S.; Abraham, William T.; Gjestvang, Finn Tore; Leclercq, Christophe; Monaghan, Mark; Nihoyannopoulos, Petros; Peraldo, Carlo; Yu, Cheuk‐Man; Demas, M.; Gerritse, Bart; Bax, Jeroen J.

doi:10.1136/hrt.2010.192542

Cited by 32 publications

(16 citation statements)

References 40 publications

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“…[11][12][13][14][15][16][17][18][19] Several other key clinical questions remain, and more data are required to inform these issues. 17,20,21 Patients with narrower QRS durations seem to have a lesser response, but is there a QRS duration cut point which can be used to guide patients selection? 17 Is the cut point different for different QRS morphologies?…”

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confidence: 99%

Impact of QRS Morphology and Duration on Outcomes After Cardiac Resynchronization Therapy

Birnie

Higginson

et al. 2013

Circ: Heart Failure

135

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Background-The impact of QRS morphology and duration on the effectiveness of cardiac resynchronization therapy (CRT) has been usually assessed separately. The interaction between these 2 simple ECG parameters and their effect on CRT has not been systematically assessed in a large-scale clinical trial. Methods and Results-The Resynchronization-Defibrillation for Ambulatory Heart Failure Trial showed that implantable cardioverter defibrillator-CRT was associated with a significant reduction in the primary end point of all-cause mortality or heart failure hospitalization. For this substudy, we excluded patients in atrial fibrillation and those with a previous pacemaker. All baseline ECGs were reviewed by a panel of 3 experienced electrocardiographers. A total of 1483 patients were included in this study. Of these, 1175 had left bundle-branch block (LBBB) and 308 had non-LBBB. In patients with LBBB receiving implantable cardioverter defibrillator-CRT, there was a reduction in the primary outcome and in each individual component of the primary outcome. Furthermore, there was continuous relationship between QRS duration and extent of benefit. In patients with non-LBBB and QRS ≥160 ms, the hazard ratio for the primary outcome was 0.52 (0.29-0.96; P=0.033); in patients with QRS <160 ms, the hazard ratio was 1.38 (0.88-2.14; P=0.155). Conclusions-In patients with LBBB, there was a continuous relationship between broader QRS and greater benefit from implantable cardioverter defibrillator-CRT. However, our data do not support the use of implantable cardioverter defibrillator-CRT in patients with non-LBBB, especially when the QRS duration is <160 ms. There may be some delayed benefit when the QRS is ≥160 ms, but this needs further investigation. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00251251.

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confidence: 99%

Impact of QRS Morphology and Duration on Outcomes After Cardiac Resynchronization Therapy

Birnie

Higginson

et al. 2013

Circ: Heart Failure

135

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“…funktion (63,63 ± 45,8 auf 93,93 ± 20,1 p = 0,048) zeigten sich signifi kante Verbesserungen in der exEMS-Gruppe. In der limEMSGruppe zeigte sich eine signifi kante Verbesserung im Bereich Vitalität (37,5 ± 6,9 auf 52,9 ± 12,5, p = 0,02 länger in Anspruch nimmt, zeigte sich auch in Untersuchungen bei CHF-Patienten, die einer Resynchronisationstherapie zugeführt wurden [ 20 ] . Auch die linksventrikuläre Wanddicke blieb bei den in dieser Studie untersuchten Patienten unverändert, wobei zu beachten ist, dass in beiden Gruppen auch vor der Einleitung der EMSTherapie Normwerte vorlagen.…”

Section: Echokardiografi Sche Datenunclassified

Elektromyostimulation: Verbesserung von Lebensqualität, Sauerstoffaufnahme und linksventrikulärer Funktion bei chronischer Herzinsuffizienz

et al. 2013

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“…Die Anwendung einer CRT bei diesem Patientengut wird analog diskrepanter Studiendaten sehr kontroversiell diskutiert [15,16]. Eine Klärung dürfte erst in einigen Jahren die derzeit laufende prospektive Echo-CRT Studie bringen [17], bei der neue komplexe echokardiographische Messungen der Dyssynchronie -in einem erfahrenen CoreLab analysiert -letztlich darüber entscheiden, welche Patienten eingeschlossen werden.…”

Section: Crt Bei Schmalen Kammerkomplexunclassified

Derzeitige klinische Praxis der kardialen Resynchronisationstherapie in Österreich – nationale Ergebnisse aus dem European CRT Survey

Dichtl

Strohmer

Fruhwald

2011

Wien Klin Wochenschr

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Cardiac resynchronization therapy (CRT) has become an established treatment modality in patients with chronic heart failure, reducing both mortality and morbidity. However, patient selection, implantation and follow-up require great clinical experience. Between 2008 and 2010, the European Society of Cardiology initiated the European CRT survey to describe the current practice and routines associated with CRT implantations in 13 countries. Data from 156 patients collected in 10 Austrian centres were analysed compared to the total 2438 patients enrolled. The survey data showed that general practice did not adhere to the present guidelines. More than one third (36%) of the patients had atrial fibrillation and more than one-fourth (29%) had had a device implanted previously. Altogether, 22% of the patients were in NYHA functional class I or II, and 18% had a LVEF > 35%. Approximately one-fourth of the patients were treated with CRT-P devices (Austria 23%, total 27%). In Austria a higher percentage of patients with non-ischemic cardiomyopathy was selected for CRT than in the other European countries (56% versus 40%, p < 0.0001). Less than a quarter of all patients were females. Different from the rest of Europe, only a minority of CRT implantations were performed by cardiologists in Austria (29% as compared to 89% throughout Europe; p < 0.0001).

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Effects of cardiac resynchronisation therapy in patients with heart failure having a narrow QRS Complex enrolled in PROSPECT

Cited by 32 publications

References 40 publications

Impact of QRS Morphology and Duration on Outcomes After Cardiac Resynchronization Therapy

Impact of QRS Morphology and Duration on Outcomes After Cardiac Resynchronization Therapy

Elektromyostimulation: Verbesserung von Lebensqualität, Sauerstoffaufnahme und linksventrikulärer Funktion bei chronischer Herzinsuffizienz

Derzeitige klinische Praxis der kardialen Resynchronisationstherapie in Österreich – nationale Ergebnisse aus dem European CRT Survey

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