Cardiac resynchronization therapy in the ageing population - With or without an implantable defibrillator?

International Journal of Cardiology
Michael DöringSergio Richter

Abstract

Cardiac resynchronization therapy (CRT) is an effective treatment option for systolic heart failure, but the benefit of an additional implantable cardioverter-defibrillator (ICD) in elderly patients is not well established. The aim of our study was to evaluate the impact of an additional ICD on survival in elderly CRT recipients. Patients aged ≥75 years with an indication for CRT and primary preventive ICD therapy, which underwent implantation of either a CRT-pacemaker (CRT-P) or CRT-defibrillator (CRT-D) were included in the study. Patient characteristics, procedural and follow-up data, and subsequent all-cause mortality were analyzed. A total of 775 consecutive patients underwent CRT implantation, whereof 177 patients fulfilled the inclusion criteria. Of these, 80 patients with CRT-P and 97 with CRT-D formed the two study groups. Patients in the CRT-P group were significantly older (82.6 ± 4.5 vs. 77.8 ± 1.9 years, p < 0.001) and more often female (44 vs. 25%; p < 0.001), had a better left ventricular ejection fraction (29.5 ± 5.7 vs. 27.4 ± 6.0%; p = 0.019) and narrower QRS-complex (150 ± 19 vs. 158 ± 18 ms; p = 0.025). During a mean follow-up of 26 ± 19 months, 62 (35%) study patients died, 28 (35%) in the CRT-P and 34 (35%...Continue Reading

Citations

Mar 19, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Andreas GoetteUNKNOWN ESC Scientific Document Group
Dec 12, 2018·The Cochrane Database of Systematic Reviews·Mohamad El MohebMarwan Refaat
May 23, 2019·Arrhythmia & Electrophysiology Review·Wei-Yao LimRichard J Schilling
Jun 28, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Nikolaos Dagres, Gerhard Hindricks
Dec 30, 2020·Pacing and Clinical Electrophysiology : PACE·Yu-Xiang LongZeng-Zhang Liu
Nov 14, 2020·Pacing and Clinical Electrophysiology : PACE·László HejjelAttila Kónyi

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