Author + information
- Aafke Van Der Heiden,
- Ulas Hoke,
- Jan Willem Borleffs,
- Joep Thijssen,
- Johannes van Rees,
- Enno Van Der Velde,
- Martin Schalij and
- Lieselot van Erven
Cardiac resynchronization therapy-defibrillator [CRT-D] implantation has demonstrated to reduce mortality in selected heart failure patients. Small studies report patients with major improvement in left ventricular ejection fraction. Data of prognosis in these CRT-D super responders is scarce.
All patients who underwent CRT-D implantation at Leiden University Medical Center are divided in subgroups according reduction of left ventricular end-systolic volume [LVESV], 6 months after implantation. Subgroups are: negative responders (increased LVESV) and super responders (decreased LVESV>30%), remaining patients are excluded. For deceased, mode of death is retrieved from hospital or general practitioner records.
Of 1312 CRT-D recipients, this study includes 445 patients (215 negative; 230 super responders). During a median follow up of 47±41 months, 84 (39%) negative and 52 (23%) super responders died (p=0.001). Cardiac death occurred in 43 (51%) negative and 18 (35%) super responders (p=0.07), from which 35 (42%) negative and 13 (25%) super responders died of heart failure (p<0.05). Non cardiac death occurred 24 (29%) negative and 25 (48%) super responders (p=0.001), respectively 6 (7%) and 11 (21%) died due to malignant neoplasm (p<0.01).
In clinical practice CRT-D super responders have lower mortality compared to negative responders. Super responders die less of cardiac deaths (heart failure), but more of non cardiac death (malignant neoplasm).
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Heart Failure: Cardiac Resynchronization Therapy
Abstract Category: 17. Heart Failure: Therapy
Presentation Number: 1177-303
- 2013 American College of Cardiology Foundation