Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/14933
Title: Cardiac resynchronization therapy with or without defibrillator: experience from a high-volume Belgian implantation centre
Authors: VERBRUGGE, Frederik 
DE VUSSER, Philip 
Rivero-Ayerza, Maximo
Van Herendael, Hugo
Rondelez, Koen
DUPONT, Matthias 
VROLIX, Mathias 
VAN KERREBROECK, Christiaan 
Verhaert, David
VANDERVOORT, Pieter 
MULLENS, Wilfried 
Issue Date: 2013
Publisher: ACTA CARDIOLOGICA
Source: ACTA CARDIOLOGICA, 68 (1), p. 37-45
Abstract: Objective Cardiac resynchronization therapy (CRT) is an important treatment modality for heart failure with reduced ejection fraction and ventricular conduction delay. Considering limited health care budgets in an aging population, adding a defibrillator function to CRT remains a matter of debate. Our aim was to describe the experience of a high-volume Belgian implantation centre with CRT with/without defibrillator (CRT-D/P). Methods and results Consecutive CRT patients (n=221), implanted between October 2008 and April 2011 in Ziekenhuis Oost-Limburg (Genk), were reviewed. From 209 primo-implantations, 74 CRT-D and 98 CRT-P patients with complete follow-up inside the centre, were analysed. Despite differences in baseline characteristics, both groups demonstrated similar reverse left ventricular remodelling, improvement in New York Heart Association functional class and maximal aerobic capacity. During mean follow-up of 18 +/- 9 months, 21 patients died and 83 spent a total of 1200 days in hospital. Annual mortality was 8% and equal among the groups. The mode of death differed between CRT-D (predominantly pump failure) and CRT-P patients (pump failure, comorbidity and sudden death).The yearly population attributable risk of malignant ventricular arrhythmia was 8.16% in CRT-D and 1.38% in CRT-P patients. Conclusions With current guidelines applied to the Belgian reimbursement criteria and at physicians' discretion, patient selection for CRT-D/CRT-P was appropriate, with similar reverse remodelling, functional capacity improvement and good clinical outcome in both groups. High-risk patients for malignant ventricular arrhythmia were more likely to receive CRT-D, although the yearly attributable risk remained 1.38% in CRT-P patients.
Notes: [Verbrugge, Frederik H.; De Vusser, Philippe; Rivero-Ayerza, Maximo; Van Herendael, Hugo; Rondelez, Koen; Dupont, Matthias; Vrolix, Mathias; Verhaert, David; Vandervoort, Pieter; Mullens, Wilfried] Ziekenhuis Oost Limburg, Dept Cardiol, B-3600 Genk, Belgium. [Verbrugge, Frederik H.] Hasselt Univ, Doctoral Sch Med & Life Sci, Diepenbeek, Belgium. [Van Kerrebroeck, Christiaan] Ziekenhuis Oost Limburg, Dept Cardiac Surg, B-3600 Genk, Belgium. [Verhaert, David; Vandervoort, Pieter; Mullens, Wilfried] Hasselt Univ, Fac Med & Life Sci, Biomed Res Inst, Diepenbeek, Belgium.
Keywords: Cardiac & Cardiovascular Systems;Cardiac resynchronization therapy; epidemiology; implantable cardioverter/defibrillator; outcome
Document URI: http://hdl.handle.net/1942/14933
ISSN: 0001-5385
e-ISSN: 1784-973X
DOI: 10.2143/AC.68.1.2959630
ISI #: 000315178300006
Category: A1
Type: Journal Contribution
Validations: ecoom 2014
Appears in Collections:Research publications

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