Author + information
- Enrique Galve Basilio,
- Gerard Oristrell Santamaria,
- Gabriel Acosta,
- Aida Ribera,
- Moya Angel,
- Ferreira Ignacio,
- Perez-Rodon Jordi,
- Garcia-Dorado David and
- Enrique Galve
Background: Once ICD has been implanted, device therapies worsen prognosis. Our hypothesis was that CRT-D may reduce number of first appropriate ICD therapy, and that independent factors can be identified.
Methods: 175 consecutive patients (age 64.6±10.4 years, 23 [13.1%] women), left ventricular ejection fraction (LVEF) 27.9 ± 7.6% (range 10-50%), 97 of ischemic origin, were treated, according to standard indications, with an ICD (in 80 cases the device was CRT-D) and followed-up during 2.5±1.5 years. Devices were placed for either primary (n=95) or secondary prevention (n=80).
Results: 44 (25.1%) patients received at least one appropriate therapy, 11.55 (8.57-15.57) per 100 patient-years. In the multivariable analysis, indication for secondary prevention was associated with a higher risk of first appropriate therapy (HR 3.42 [1.36-8.57] p=0.009), and CRT-D was associated to a lower risk of first therapy (0.31 [0.11-0.88] p=0.027). This reduction was present across all subgroups, even in patients in primary prevention (p=0.05), and although patients treated with CRT-D had significant lower ejection fraction and poorer NYHA class that their counterparts. In the follow-up, LVEF in patients with CRT-D improved from 25,3% (5,6) to 37,0% (5,6) (p=0.001). There were no differences in mortality in patients with and without CRT.
Conclusions: Although patients receiving CRT-D have a worse clinical profile, they receive less device therapies in comparison to those receiving an ICD; this reduction is associated with significant improvement in LV function.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Atrial Fibrillation and VT: Unique Populations and Solutions
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1151-100
- 2017 American College of Cardiology Foundation