Risk of ventricular arrhythmia in cardiac resynchronization therapy responders and super-responders: a systematic review and meta-analysis
| Autor: | Jacob Joseph, Hirad Yarmohammadi, Jagmeet P. Singh, Peter Hoffmeister, Sebhat A. Erqou, David Martin, Adelqui Peralta, Matthew F Yuyun, Justin B. Echouffo Tcheugui |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Cardiac resynchronization therapy Ventricular Function Left Cardiac Resynchronization Therapy Physiology (medical) Internal medicine medicine Humans Cumulative incidence Heart Failure Ejection fraction business.industry Absolute risk reduction Arrhythmias Cardiac Stroke Volume medicine.disease Implantable cardioverter-defibrillator Confidence interval Defibrillators Implantable Treatment Outcome Relative risk Heart failure Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | EP Europace. 23:1262-1274 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Aims Response to cardiac resynchronization therapy (CRT) is associated with improved survival, and reduction in heart failure hospitalization, and ventricular arrhythmia (VA) risk. However, the impact of CRT super-response [CRT-SR, increase in left ventricular ejection fraction (LVEF) to ≥ 50%] on VA remains unclear. Methods and results We undertook a meta-analysis aimed at determining the impact of CRT response and CRT-SR on risk of VA and all-cause mortality. Systematic search of PubMed, EMBASE, and Cochrane databases, identifying all relevant English articles published until 31 December 2019. A total of 34 studies (7605 patients for VA and 5874 patients for all-cause mortality) were retained for the meta-analysis. The pooled cumulative incidence of appropriate implantable cardioverter-defibrillator therapy for VA was significantly lower at 13.0% (4.5% per annum) in CRT-responders, vs. 29.0% (annualized rate of 10.0%) in CRT non-responders, relative risk (RR) 0.47 [95% confidence interval (CI) 0.39–0.56, P Conclusions Cardiac resynchronization therapy super-responders have low absolute risk of VA and all-cause mortality. However, there remains a non-trivial residual absolute risk of these adverse outcomes in CRT responders. These findings suggest that among CRT responders, there may be a continued clinical benefit of defibrillators. |
| Databáze: | OpenAIRE |
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