| Autor: |
Zandi, Zahra, Eslami, Masoud, Kamali, Farzad, Teimouri-jervekani, Zahra, Taherpour, Mehdi, Mollazadeh, Reza, Haghjoo, Majid, Fazelifar, Amir Farjam, Alizadeh, Abolfath, Madadi, Shabnam, Hosseini Selki Sar, Sajjad, Emkanjoo, Zahra |
| Zdroj: |
Acta cardiologica; March 2024, Vol. 79 Issue: 3 p338-343, 6p |
| Abstrakt: |
AbstractBackgroundThe clinical safety and consequences of upgrade procedures compared with de novocardiac resynchronisation therapy (CRT) implantation in heart failure remain unclear. The present study aimed to assess clinical and procedural consequences of patients undergoing CRT upgrade as compared to de novoCRT implantations.MethodsIn this prospective cohort study, two subgroups were considered as the study population as (1) de novogroup that CRT was considered on optimised medical treatment with heart failure of NYHA functional class from II to IV, left ventricular ejection fraction (LVEF) of ≤35%, and QRS width of >130 ms and (2) upgrade group including the patients with previously implantable cardioverter defibrillator (ICD) with the indications for upgrading to CRT. The two groups were compared regarding the changes in clinical outcome and echocardiography parameters.ResultsThe procedure was successful in 95.9% of patients who underwent CRT upgrade and 100% of those who underwent de novoCRT implantation. It showed a significant improvement in LVEF, severity of mitral regurgitation and NYHA functional classification, without any difference between the two study groups. Overall procedural related complications were reported in 10.8% and 3.8% (p = .093) and cardiac death in 5.4% and 2.5% (p = .360), respectively, with no overall difference in postoperative outcome between the two groups.ConclusionsUpgrading to CRT is a safe and effective procedure regarding improvement of functional class, left ventricular function status and post-procedural outcome. |
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