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Ventricular high-rate episodes predict increased mortality in heart failure patients treated with cardiac resynchronization therapy.

Jacobsson, Jonatan LU ; Reitan, Christian LU ; Platonov, Pyotr LU and Borgquist, Rasmus LU (2015) In Scandinavian Cardiovascular Journal 49(1). p.20-26
Abstract
Abstract Objectives. Cardiac Resynchronization Therapy (CRT) for heart-failure patients has a well-documented positive effect, but the overall mortality in this group remains high. This study aimed to explore whether additional information from the device post-implant (occurrence of ventricular high-rate episodes), could add prognostic value for patients on CRT-pacemaker (CRT-P) treatment. Design. Clinical data and device-interrogation data were retrospectively gathered from the medical records of 220 patients treated with CRT-P. Ventricular high-rate (VHR) episodes were defined as a ventricular rate ≥ 180 beats per minute. The primary outcome was 5-year mortality. Results. During follow-up, 132 patients (60%) died or underwent heart... (More)
Abstract Objectives. Cardiac Resynchronization Therapy (CRT) for heart-failure patients has a well-documented positive effect, but the overall mortality in this group remains high. This study aimed to explore whether additional information from the device post-implant (occurrence of ventricular high-rate episodes), could add prognostic value for patients on CRT-pacemaker (CRT-P) treatment. Design. Clinical data and device-interrogation data were retrospectively gathered from the medical records of 220 patients treated with CRT-P. Ventricular high-rate (VHR) episodes were defined as a ventricular rate ≥ 180 beats per minute. The primary outcome was 5-year mortality. Results. During follow-up, 132 patients (60%) died or underwent heart transplant. Overall, the 5-year mortality rate was 52%; 77% for patients with VHR during the first year of follow-up and 48% for patients without VHR during the first year of follow-up (p = 0.001). In a multivariate model, the occurrence of VHR episodes was an independent predictor of 5-year mortality (HR 9.96, p = 0.022). The most common cause of death was heart failure, and death from arrhythmia did not differ between groups (p = 0.065). Conclusions. In heart-failure patients with CRT-P therapy, occurrence of VHR episodes within the first year post-implant was an independent predictor of higher 5-year mortality and inferior long-term survival, but not of death from malignant arrhythmia. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Cardiovascular Journal
volume
49
issue
1
pages
20 - 26
publisher
Taylor & Francis
external identifiers
  • pmid:25658030
  • wos:000350104900004
  • scopus:84923351020
ISSN
1651-2006
DOI
10.3109/14017431.2015.1006245
language
English
LU publication?
yes
id
43ffb65a-2813-4b71-aa16-6a22b5ac0fe3 (old id 5145284)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25658030?dopt=Abstract
date added to LUP
2015-03-04 19:01:05
date last changed
2017-01-12 14:14:15
@article{43ffb65a-2813-4b71-aa16-6a22b5ac0fe3,
  abstract     = {Abstract Objectives. Cardiac Resynchronization Therapy (CRT) for heart-failure patients has a well-documented positive effect, but the overall mortality in this group remains high. This study aimed to explore whether additional information from the device post-implant (occurrence of ventricular high-rate episodes), could add prognostic value for patients on CRT-pacemaker (CRT-P) treatment. Design. Clinical data and device-interrogation data were retrospectively gathered from the medical records of 220 patients treated with CRT-P. Ventricular high-rate (VHR) episodes were defined as a ventricular rate ≥ 180 beats per minute. The primary outcome was 5-year mortality. Results. During follow-up, 132 patients (60%) died or underwent heart transplant. Overall, the 5-year mortality rate was 52%; 77% for patients with VHR during the first year of follow-up and 48% for patients without VHR during the first year of follow-up (p = 0.001). In a multivariate model, the occurrence of VHR episodes was an independent predictor of 5-year mortality (HR 9.96, p = 0.022). The most common cause of death was heart failure, and death from arrhythmia did not differ between groups (p = 0.065). Conclusions. In heart-failure patients with CRT-P therapy, occurrence of VHR episodes within the first year post-implant was an independent predictor of higher 5-year mortality and inferior long-term survival, but not of death from malignant arrhythmia.},
  author       = {Jacobsson, Jonatan and Reitan, Christian and Platonov, Pyotr and Borgquist, Rasmus},
  issn         = {1651-2006},
  language     = {eng},
  number       = {1},
  pages        = {20--26},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Cardiovascular Journal},
  title        = {Ventricular high-rate episodes predict increased mortality in heart failure patients treated with cardiac resynchronization therapy.},
  url          = {http://dx.doi.org/10.3109/14017431.2015.1006245},
  volume       = {49},
  year         = {2015},
}