Introduction: Cardiac resynchronization therapy (CRT) is, as recommended in the European Society of Cardiology (ESC) guidelines, a treatment for patients with advanced systolic heart failure. The aim of this study was to evaluate patient characteristics, adherence to guidelines, complications and outcome of patients treated with CRT in clinical practice.
Methods: A retrospective analysis was performed on 114 patients receiving a de novo CRT device in the Universitair Ziekenhuis Brussel between January 2011 and May 2014. Demographic, clinical, echocardiographic, biochemical, implantation and device related data were collected at baseline, six months and one year follow-up. During the one year follow-up, all-cause mortality was registered for all patients.
Results: The baseline patient characteristics were largely similar to those in other observational studies, although 40% of patients did not meet the ESC guidelines. One in five patients encountered a procedure or device related complication. There was a statistically significant amelioration of the NYHA clinical score (p < 0.001). An amelioration of cardiac function and structure was seen, with a significantly higher left ventricle ejection fraction after 6 months (p = 0.020). The all-cause mortality one year after CRT device implantation was 8.1%.
Conclusions: This observational study is a representation of CRT treatment in clinical practice. A considerable part of the patient cohort did not meet the ESC guideline recommendations for CRT implantation. Although a favourable evolution after CRT implantation was seen, there is still a certain risk of encountering complications. Therefore, further investigations on inclusion of patients not eligible for CRT according to ESC guidelines should be performed.
|1 jun 2015
- Vrije Universiteit Brussel
|Caroline Weytjens (Promotor) & Steven Droogmans (Co-promotor)
- Cardiac resynchronization therapy