Author + information
- Vanessa Blumer,
- Luis Arcay,
- Gabriel A. Hernandez,
- Jorge Monge,
- Juan Viles-Gonzalez,
- Jeffrey Goldberger and
- Sandra Chaparro
Background: Trials have proven cardiac resynchronization therapy (CRT) to be beneficial in certain subgroups of patients with heart failure (HF). Patients with end-stage inotrope-dependent HF have not been included in these trials. It is currently undetermined if CRT may benefit inotrope-supported patients with end-stage HF.
Methods: We performed a comprehensive search of Medline, Cochrane library, Scopus, and Embase for publications evaluating the use of CRT in inotrope-dependent HF patients. We performed a random-effects meta-analysis using pooled proportions and heterogeneity was examined using I2 statistics.
Results: A total of 6 studies including 75 inotrope-dependent HF patients (age 64±10 years, 88% men, 60% ICMP, 40% NICMP, LVEF 19.8±4.8%, QRS duration 174±29 ms, 100% NYHA IV) undergoing CRT implantation were included in the analysis. Of these 75 patients, 95% (95% CI 88-100%) were able to be weaned off inotropic support after CRT implantation, 9% (95% CI 1-18%) remained NYHA Class IV, and 12 month overall survival was 70% (95% CI 55-86%).
Conclusions: Our systematic review suggests that CRT is a plausible option in selected patients with end-stage inotrope-dependent HF, allowing discontinuation of inotropes and a reasonable life expectancy. Non-uniform and unspecified enrollment criteria may confound the precise delineation of this population. Further studies are needed to identify the optimal criteria to identify CRT responders among patients with end-stage inotrope-dependent HF.
Moderated Poster Contributions
Heart Failure and Cardiomyopathies Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 11:00 a.m.-11:10 a.m.
Session Title: Why Can't We Be Friends? Controversies in Heart Failure Management
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1137M-11
- 2017 American College of Cardiology Foundation