Opportunity to increase life span in narrow QRS cardiac resynchronization therapy recipients by deactivating ventricular pacing: evidence from randomized controlled trials

JACC. Heart Failure
S M Afzal SohaibZachary I Whinnett

Abstract

This study examined the time course of clinical events in cardiac resynchronization therapy (CRT) trials. Recent randomized controlled trial results suggest that in heart failure with narrow QRS, biventricular pacing (CRT) may increase mortality. The authors proposed implant complications as the cause, rather than a progressive adverse physiological effect. The study identified all trials comparing CRT with no CRT, which reported Kaplan-Meier curves in groups defined by QRS: narrow, non-left bundle branch block (LBBB) broad, and LBBB broad. For each trial, the change in life span every 3 months up to 3.5 years (the longest time for which data are available) was calculated and a power law was fitted, that is, ∝ time(n). Four trials (MADIT-CRT [Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy], RAFT [Resynchronization-Defibrillation for Ambulatory Heart Failure Trial], REVERSE [REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction], and EchoCRT [Echocardiography Guided Cardiac Resynchronization Therapy]), totaling 4,717 patients, reported curves for mortality or heart failure-related hospitalization, or for mortality. In patients with LBBB broad QRS (within MADIT-CR...Continue Reading

References

Mar 22, 2001·The New England Journal of Medicine·S CazeauUNKNOWN Multisite Stimulation in Cardiomyopathies (MUSTIC) Study Investigators
Oct 5, 2001·Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology·J A Salerno-Uriarte, M Tritto
Sep 16, 2003·The American Journal of Cardiology·Kenneth A EllenbogenGervasio A Lamas
May 21, 2004·The New England Journal of Medicine·Michael R BristowUNKNOWN Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators
Mar 15, 2006·Circulation·Wayne C LevyMilton Packer
Nov 29, 2008·Journal of the American College of Cardiology·Cecilia LindeUNKNOWN REVERSE (REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction) Study Group
Nov 16, 2010·The New England Journal of Medicine·Anthony S L TangUNKNOWN Resynchronization-Defibrillation for Ambulatory Heart Failure Trial Investigators
Dec 20, 2011·European Journal of Heart Failure·Nigussie BogaleUNKNOWN Scientific Committee, National Coordinators, and Investigators
Oct 13, 2012·JACC. Cardiovascular Imaging·Sukhjinder S NijjerDarrel P Francis
Jan 15, 2013·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·Syed Y AhsanAnthony W C Chow
May 4, 2013·European Heart Journal·Cecilia LindeUNKNOWN REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction Study Group
Sep 4, 2013·The New England Journal of Medicine·Frank RuschitzkaUNKNOWN EchoCRT Study Group
Nov 22, 2013·European Journal of Heart Failure·S M Afzal SohaibDarrel P Francis
Apr 1, 2014·The New England Journal of Medicine·Ilan GoldenbergArthur J Moss
Apr 24, 2014·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·Fernando ArribasKatja Zeppenfeld

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Citations

Mar 17, 2015·JACC. Heart Failure·John G F Cleland, Charles Butcher
Aug 26, 2017·Medical & Biological Engineering & Computing·Nuria OrtigosaAntonio Galbis
Jul 10, 2018·Expert Review of Cardiovascular Therapy·Baldeep S SidhuChristopher A Rinaldi
Jul 29, 2020·European Journal of Heart Failure·Søren Lund KristensenUNKNOWN PARADIGM-HF and ATMOSPHERE Committees and Investigators.
May 8, 2020·Cardiovascular Diabetology·Bo LiangNing Gu
Jan 18, 2020·Medicina·Paulius BašinskasTomas Kazakevičius
Aug 28, 2021·European Heart Journal·Theresa A McDonaghUNKNOWN ESC Scientific Document Group
Oct 20, 2021·Journal of Cardiovascular Electrophysiology·Antonis S ManolisHelen Melita

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