Very long-term survival and late sudden cardiac death in cardiac resynchronization therapy patients

Barra, Sérgio; Duehmke, Rudolf; Providência, Rui; Narayanan, Kumar; Reitan, Christian; Roubicek, Tomas; Polasek, Rostislav; Chow, Antony; Defaye, Pascal; Fauchier, Laurent; Piot, Olivier; Deharo, Jean-Claude; Sadoul, Nicolas; Klug, Didier; Garcia, Rodrigue; Dockrill, Seth; Virdee, Munmohan; Pettit, Stephen; Agarwal, Sharad; Borgquist, Rasmus; Marijon, Eloi; Boveda, Serge

Very long-term survival and late sudden cardiac death in cardiac resynchronization therapy patients

Mark

Barra, Sérgio ; Duehmke, Rudolf ; Providência, Rui ; Narayanan, Kumar ; Reitan, Christian ^LU ; Roubicek, Tomas ; Polasek, Rostislav ; Chow, Antony ; Defaye, Pascal and Fauchier, Laurent , et al. (2019) In European Heart Journal 40(26). p.2121-2127

Abstract

AIMS: The very long-term outcome of patients who survive the first few years after receiving cardiac resynchronization therapy (CRT) has not been well described thus far. We aimed to provide long-term outcomes, especially with regard to the occurrence of sudden cardiac death (SCD), in CRT patients without (CRT-P) and with defibrillator (CRT-D).

METHODS AND RESULTS: A total of 1775 patients, with ischaemic or non-ischaemic dilated cardiomyopathy, who were alive 5 years after CRT implantation, were enrolled in this multicentre European observational cohort study. Overall long-term mortality rates and specific causes of death were assessed, with a focus on late SCD. Over a mean follow-up of 30 months (interquartile range 10-42... (More)

AIMS: The very long-term outcome of patients who survive the first few years after receiving cardiac resynchronization therapy (CRT) has not been well described thus far. We aimed to provide long-term outcomes, especially with regard to the occurrence of sudden cardiac death (SCD), in CRT patients without (CRT-P) and with defibrillator (CRT-D).

METHODS AND RESULTS: A total of 1775 patients, with ischaemic or non-ischaemic dilated cardiomyopathy, who were alive 5 years after CRT implantation, were enrolled in this multicentre European observational cohort study. Overall long-term mortality rates and specific causes of death were assessed, with a focus on late SCD. Over a mean follow-up of 30 months (interquartile range 10-42 months) beyond the first 5 years, we observed 473 deaths. The annual age-standardized mortality rates of CRT-D and CRT-P patients were 40.4 [95% confidence interval (CI) 35.3-45.5] and 97.2 (95% CI 85.5-109.9) per 1000 patient-years, respectively. The adjusted hazard ratio (HR) for all-cause mortality was 0.99 (95% CI 0.79-1.22). Twenty-nine patients in total died of late SCD (14 with CRT-P, 15 with CRT-D), corresponding to 6.1% of all causes of death in both device groups. Specific annual SCD rates were 8.5 and 5.8 per 1000 patient-years in CRT-P and CRT-D patients, respectively, with no significant difference between groups (adjusted HR 1.0, 95% CI 0.45-2.44). Death due to progressive heart failure represented the principal cause of death (42.8% in CRT-P patients and 52.6% among CRT-D recipients), whereas approximately one-third of deaths in both device groups were due to non-cardiovascular death.

CONCLUSION: In this first description of very long-term outcomes among CRT recipients, progressive heart failure death still represented the most frequent cause of death in patients surviving the first 5 years after CRT implant. In contrast, SCD represents a very low proportion of late mortality irrespective of the presence of a defibrillator.

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Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/091f6551-51a2-42ba-83ea-df10839fc727

author

Barra, Sérgio ; Duehmke, Rudolf ; Providência, Rui ; Narayanan, Kumar ; Reitan, Christian ^LU ; Roubicek, Tomas ; Polasek, Rostislav ; Chow, Antony ; Defaye, Pascal and Fauchier, Laurent , et al. (More)

Barra, Sérgio ; Duehmke, Rudolf ; Providência, Rui ; Narayanan, Kumar ; Reitan, Christian ^LU ; Roubicek, Tomas ; Polasek, Rostislav ; Chow, Antony ; Defaye, Pascal ; Fauchier, Laurent ; Piot, Olivier ; Deharo, Jean-Claude ; Sadoul, Nicolas ; Klug, Didier ; Garcia, Rodrigue ; Dockrill, Seth ; Virdee, Munmohan ; Pettit, Stephen ; Agarwal, Sharad ; Borgquist, Rasmus ^LU

; Marijon, Eloi and Boveda, Serge (Less)

organization

publishing date

2019-07-07

type

Contribution to journal

publication status

published

subject

Cardiac and Cardiovascular Systems

in

European Heart Journal

volume

40

issue

26

pages

2121 - 2127

publisher

Oxford University Press

external identifiers

pmid:31046090
scopus:85069294863

ISSN

1522-9645

DOI

10.1093/eurheartj/ehz238

language

English

LU publication?

yes

additional info

id

091f6551-51a2-42ba-83ea-df10839fc727

date added to LUP

2019-05-22 20:44:26

date last changed

2024-05-14 10:16:40

@article{091f6551-51a2-42ba-83ea-df10839fc727,
  abstract     = {{<p>AIMS: The very long-term outcome of patients who survive the first few years after receiving cardiac resynchronization therapy (CRT) has not been well described thus far. We aimed to provide long-term outcomes, especially with regard to the occurrence of sudden cardiac death (SCD), in CRT patients without (CRT-P) and with defibrillator (CRT-D).</p><p>METHODS AND RESULTS: A total of 1775 patients, with ischaemic or non-ischaemic dilated cardiomyopathy, who were alive 5 years after CRT implantation, were enrolled in this multicentre European observational cohort study. Overall long-term mortality rates and specific causes of death were assessed, with a focus on late SCD. Over a mean follow-up of 30 months (interquartile range 10-42 months) beyond the first 5 years, we observed 473 deaths. The annual age-standardized mortality rates of CRT-D and CRT-P patients were 40.4 [95% confidence interval (CI) 35.3-45.5] and 97.2 (95% CI 85.5-109.9) per 1000 patient-years, respectively. The adjusted hazard ratio (HR) for all-cause mortality was 0.99 (95% CI 0.79-1.22). Twenty-nine patients in total died of late SCD (14 with CRT-P, 15 with CRT-D), corresponding to 6.1% of all causes of death in both device groups. Specific annual SCD rates were 8.5 and 5.8 per 1000 patient-years in CRT-P and CRT-D patients, respectively, with no significant difference between groups (adjusted HR 1.0, 95% CI 0.45-2.44). Death due to progressive heart failure represented the principal cause of death (42.8% in CRT-P patients and 52.6% among CRT-D recipients), whereas approximately one-third of deaths in both device groups were due to non-cardiovascular death.</p><p>CONCLUSION: In this first description of very long-term outcomes among CRT recipients, progressive heart failure death still represented the most frequent cause of death in patients surviving the first 5 years after CRT implant. In contrast, SCD represents a very low proportion of late mortality irrespective of the presence of a defibrillator.</p>}},
  author       = {{Barra, Sérgio and Duehmke, Rudolf and Providência, Rui and Narayanan, Kumar and Reitan, Christian and Roubicek, Tomas and Polasek, Rostislav and Chow, Antony and Defaye, Pascal and Fauchier, Laurent and Piot, Olivier and Deharo, Jean-Claude and Sadoul, Nicolas and Klug, Didier and Garcia, Rodrigue and Dockrill, Seth and Virdee, Munmohan and Pettit, Stephen and Agarwal, Sharad and Borgquist, Rasmus and Marijon, Eloi and Boveda, Serge}},
  issn         = {{1522-9645}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{26}},
  pages        = {{2121--2127}},
  publisher    = {{Oxford University Press}},
  series       = {{European Heart Journal}},
  title        = {{Very long-term survival and late sudden cardiac death in cardiac resynchronization therapy patients}},
  url          = {{http://dx.doi.org/10.1093/eurheartj/ehz238}},
  doi          = {{10.1093/eurheartj/ehz238}},
  volume       = {{40}},
  year         = {{2019}},
}

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Very long-term survival and late sudden cardiac death in cardiac resynchronization therapy patients