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Title: | Landmark Evolutions in Time and Indication for Cardiac Resynchronization Therapy: Results from a Multicenter Retrospective Registry | Authors: | Bijnens , Jeroen Trenson, Sander Voros, Gabor MARTENS, Pieter Ingelaere, Sebastian Betschart, Pascal Voigt, Jens-Uwe DUPONT, Matthias Breitenstein, Alexander Steffel, Jan Willems , Rik Ruschitzka, Frank MULLENS, Wilfried Winnik, Stephan Vandenberk, Bert |
Issue Date: | 2024 | Publisher: | MDPI | Source: | Journal of Clinical Medicine, 13 (7) (Art N° 1903) | Abstract: | Background: Cardiac resynchronization therapy (CRT) has evolved into an established therapy for patients with chronic heart failure and a wide QRS complex. Data on long-term outcomes over time are scarce and the criteria for implantation remain a subject of investigation. Methods: An international, multicenter, retrospective registry includes 2275 patients who received CRT between 30 November 2000 and 31 December 2019, with a mean follow-up of 3.6 +/- 2.7 years. Four time periods were defined, based on landmark trials and guidelines. The combined endpoint was a composite of all-cause mortality, heart transplantation, or left ventricular assist device implantation. Results: The composite endpoint occurred in 656 patients (29.2%). The mean annual implantation rate tripled from 31.5 +/- 17.4/year in the first period to 107.4 +/- 62.4/year in the last period. In the adjusted Cox regression analysis, the hazard ratio for the composite endpoint was not statistically different between time periods. When compared to sinus rhythm with left bundle branch block (LBBB), a non-LBBB conduction pattern (sinus rhythm: HR 1.51, 95% CI 1.12-2.03; atrial fibrillation: HR 2.08, 95% CI 1.30-3.33) and a QRS duration below 130 ms (HR 1.64, 95% CI 1.29-2.09) were associated with a higher hazard ratio. Conclusions: Despite innovations, an adjusted regression analysis revealed stable overall survival over time, which can at least partially be explained by a shift in patient characteristics. | Notes: | Vandenberk, B (corresponding author), Univ Hosp Leuven, Dept Cardiol, B-3000 Leuven, Belgium.; Vandenberk, B (corresponding author), Katholieke Univ Leuven, Dept Cardiovasc Sci, B-3000 Leuven, Belgium. gabor.voros@uzleuven.be; matthiasdupont@hotmail.com; vandenberkbert@gmail.com |
Keywords: | cardiac resynchronization therapy;electrophysiology;heart failure;implantable;pacemaker | Document URI: | http://hdl.handle.net/1942/42965 | e-ISSN: | 2077-0383 | DOI: | 10.3390/jcm13071903 | ISI #: | 001200847600001 | Rights: | 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/ | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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Landmark Evolutions in Time and Indication for Cardiac Resynchronization Therapy.pdf | Published version | 1.04 MB | Adobe PDF | View/Open |
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