Predictors of long‐term survival in Japanese patients with heart failure with reduced ejection fraction (HFrEF) treated with cardiac resynchronization therapy‐defibrillators (CRT‐D)

Abstract

BackgroundReports on the factors predicting long‐term survival of CRT‐D cases from Western countries are increasing, however, those from Asia including Japan are still sparse. We aimed to clarify the factors predicting long‐term survival of Japanese CRT‐D cases.MethodsWe retrospectively analyzed consecutive 133 patients who underwent CRT‐D implantation between 2006 and 2021. We compared clinical factors between patients who died within 5 years after implantation (short‐survival group: n = 31) and who had survived for more than 5 years (long‐survival group: n = 36) after implantation.ResultsMajor underlying heart diseases were dilated cardiomyopathy (45%) and ischemic heart disease (12%). There was no difference between the short‐survival group and the long‐survival group in incidence of CLBBB (32% vs. 30%), whereas CRBBB was more common in the short‐survival group (26% vs. 0%, p = .004). Mechanical dyssynchrony at implantation was more frequent in the long‐survival group (48% vs. 78%, p = .02). The incidence of response to CRT at 1 year after implantation was higher in long‐survival group (19% vs. 50%, p = .02). Multiple logistic regression analysis identified NYHA class, mechanical dyssynchrony at implantation, and response at one year as predictors of long‐term survival.ConclusionsIn Japanese CRT‐D cases, lower NHYA class, preexisting mechanical dyssynchrony, and 1‐year response to CRT predict long‐term survival.