Implantable Cardioverter-Defibrillator Patients Who Are Upgraded and Respond to Cardiac Resynchronization Therapy Have Less Ventricular Arrhythmias Compared With Nonresponders
Objectives The purpose of this study was to evaluate the impact of upgrading implantable cardioverter-defibrillator (ICD) therapy to cardiac resynchronization therapy (CRT) combined with defibrillator (CRT-D) on the occurrence of ventricular arrhythmia (VA) and appropriate ICD therapies. Background...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2011-11, Vol.58 (22), p.2282-2289 |
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| creator | Thijssen, Joep, MD Borleffs, C. Jan Willem, MD, PhD Delgado, Victoria, MD, PhD van Rees, Johannes B., MD Mooyaart, Eline A.Q., MD van Bommel, Rutger J., MD van Erven, Lieselot, MD, PhD Boersma, Eric, PhD Bax, Jeroen J., MD, PhD Schalij, Martin J., MD, PhD |
| description | Objectives The purpose of this study was to evaluate the impact of upgrading implantable cardioverter-defibrillator (ICD) therapy to cardiac resynchronization therapy (CRT) combined with defibrillator (CRT-D) on the occurrence of ventricular arrhythmia (VA) and appropriate ICD therapies. Background CRT has been shown to improve left ventricular (LV) systolic function and induce reverse LV remodeling. In addition, it has been hypothesized that CRT may reduce the incidence of VA. Methods Heart failure patients receiving an upgrade from ICD to CRT-D were evaluated. Patients were considered responders to CRT if LV end-systolic volume reduced ≥15% at 6 months of follow-up. Episodes of VA, triggering device therapy (anti-tachycardia pacing and shocks) were recorded before and after upgrade for the overall population. In addition, these outcomes were compared between CRT responders and nonresponders during the follow-up period after CRT response was assessed. Results One hundred fifteen patients (93 males [81%], age 65 ± 12 years) were evaluated during a mean follow-up of 54 ± 34 months before CRT-D upgrade and 37 ± 27 months after upgrade. In CRT responders (n = 70), the frequency of VA requiring appropriate device therapy demonstrated a trend toward a decrease from 0.51 ± 0.79 to 0.30 ± 0.59 per patient per year after CRT-D upgrade (p = 0.052). In CRT nonresponders (n = 45), the frequency of VA requiring appropriate device therapy significantly increased from 0.40 ± 0.69 to 1.21 ± 2.53 per patient per year after CRT-D upgrade (p = 0.014). Conclusions After upgrade from ICD to CRT-D, nonresponders to CRT showed a significant increase in VA burden requiring appropriate device therapy. |
| doi_str_mv | 10.1016/j.jacc.2011.08.038 |
| format | Article |
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Jan Willem, MD, PhD ; Delgado, Victoria, MD, PhD ; van Rees, Johannes B., MD ; Mooyaart, Eline A.Q., MD ; van Bommel, Rutger J., MD ; van Erven, Lieselot, MD, PhD ; Boersma, Eric, PhD ; Bax, Jeroen J., MD, PhD ; Schalij, Martin J., MD, PhD</creator><creatorcontrib>Thijssen, Joep, MD ; Borleffs, C. Jan Willem, MD, PhD ; Delgado, Victoria, MD, PhD ; van Rees, Johannes B., MD ; Mooyaart, Eline A.Q., MD ; van Bommel, Rutger J., MD ; van Erven, Lieselot, MD, PhD ; Boersma, Eric, PhD ; Bax, Jeroen J., MD, PhD ; Schalij, Martin J., MD, PhD</creatorcontrib><description>Objectives The purpose of this study was to evaluate the impact of upgrading implantable cardioverter-defibrillator (ICD) therapy to cardiac resynchronization therapy (CRT) combined with defibrillator (CRT-D) on the occurrence of ventricular arrhythmia (VA) and appropriate ICD therapies. Background CRT has been shown to improve left ventricular (LV) systolic function and induce reverse LV remodeling. In addition, it has been hypothesized that CRT may reduce the incidence of VA. Methods Heart failure patients receiving an upgrade from ICD to CRT-D were evaluated. Patients were considered responders to CRT if LV end-systolic volume reduced ≥15% at 6 months of follow-up. Episodes of VA, triggering device therapy (anti-tachycardia pacing and shocks) were recorded before and after upgrade for the overall population. In addition, these outcomes were compared between CRT responders and nonresponders during the follow-up period after CRT response was assessed. Results One hundred fifteen patients (93 males [81%], age 65 ± 12 years) were evaluated during a mean follow-up of 54 ± 34 months before CRT-D upgrade and 37 ± 27 months after upgrade. In CRT responders (n = 70), the frequency of VA requiring appropriate device therapy demonstrated a trend toward a decrease from 0.51 ± 0.79 to 0.30 ± 0.59 per patient per year after CRT-D upgrade (p = 0.052). In CRT nonresponders (n = 45), the frequency of VA requiring appropriate device therapy significantly increased from 0.40 ± 0.69 to 1.21 ± 2.53 per patient per year after CRT-D upgrade (p = 0.014). Conclusions After upgrade from ICD to CRT-D, nonresponders to CRT showed a significant increase in VA burden requiring appropriate device therapy.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2011.08.038</identifier><identifier>PMID: 22093504</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiac Resynchronization Therapy ; Cardiology ; Cardiology. Vascular system ; Cardiomyopathy ; Cardiovascular ; Confidence intervals ; Defibrillators, Implantable ; device upgrade ; Diastole ; Drug therapy ; Echocardiography ; Female ; Follow-Up Studies ; Hard disks ; Heart ; Heart attacks ; Heart failure ; Heart Failure - therapy ; Humans ; implantable cardioverter-defibrillator ; Internal Medicine ; Male ; Medical sciences ; Mortality ; Multivariate Analysis ; Patients ; Quality of Life ; Questioning ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; remodeling ; Stroke Volume ; Systole ; Tachycardia, Ventricular - prevention & control ; Ultrasonic imaging ; ventricular arrhythmias ; Ventricular Dysfunction, Left - therapy ; Ventricular Fibrillation - prevention & control ; Ventricular Remodeling</subject><ispartof>Journal of the American College of Cardiology, 2011-11, Vol.58 (22), p.2282-2289</ispartof><rights>American College of Cardiology Foundation</rights><rights>2011 American College of Cardiology Foundation</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Nov 22, 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c512t-a6cb54b8dd25232b5ab8792447919f11dd1f529f6b99726c8b1627823a7f51743</citedby><cites>FETCH-LOGICAL-c512t-a6cb54b8dd25232b5ab8792447919f11dd1f529f6b99726c8b1627823a7f51743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0735109711032281$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25255052$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22093504$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thijssen, Joep, MD</creatorcontrib><creatorcontrib>Borleffs, C. Jan Willem, MD, PhD</creatorcontrib><creatorcontrib>Delgado, Victoria, MD, PhD</creatorcontrib><creatorcontrib>van Rees, Johannes B., MD</creatorcontrib><creatorcontrib>Mooyaart, Eline A.Q., MD</creatorcontrib><creatorcontrib>van Bommel, Rutger J., MD</creatorcontrib><creatorcontrib>van Erven, Lieselot, MD, PhD</creatorcontrib><creatorcontrib>Boersma, Eric, PhD</creatorcontrib><creatorcontrib>Bax, Jeroen J., MD, PhD</creatorcontrib><creatorcontrib>Schalij, Martin J., MD, PhD</creatorcontrib><title>Implantable Cardioverter-Defibrillator Patients Who Are Upgraded and Respond to Cardiac Resynchronization Therapy Have Less Ventricular Arrhythmias Compared With Nonresponders</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives The purpose of this study was to evaluate the impact of upgrading implantable cardioverter-defibrillator (ICD) therapy to cardiac resynchronization therapy (CRT) combined with defibrillator (CRT-D) on the occurrence of ventricular arrhythmia (VA) and appropriate ICD therapies. Background CRT has been shown to improve left ventricular (LV) systolic function and induce reverse LV remodeling. In addition, it has been hypothesized that CRT may reduce the incidence of VA. Methods Heart failure patients receiving an upgrade from ICD to CRT-D were evaluated. Patients were considered responders to CRT if LV end-systolic volume reduced ≥15% at 6 months of follow-up. Episodes of VA, triggering device therapy (anti-tachycardia pacing and shocks) were recorded before and after upgrade for the overall population. In addition, these outcomes were compared between CRT responders and nonresponders during the follow-up period after CRT response was assessed. Results One hundred fifteen patients (93 males [81%], age 65 ± 12 years) were evaluated during a mean follow-up of 54 ± 34 months before CRT-D upgrade and 37 ± 27 months after upgrade. In CRT responders (n = 70), the frequency of VA requiring appropriate device therapy demonstrated a trend toward a decrease from 0.51 ± 0.79 to 0.30 ± 0.59 per patient per year after CRT-D upgrade (p = 0.052). In CRT nonresponders (n = 45), the frequency of VA requiring appropriate device therapy significantly increased from 0.40 ± 0.69 to 1.21 ± 2.53 per patient per year after CRT-D upgrade (p = 0.014). Conclusions After upgrade from ICD to CRT-D, nonresponders to CRT showed a significant increase in VA burden requiring appropriate device therapy.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiac Resynchronization Therapy</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiomyopathy</subject><subject>Cardiovascular</subject><subject>Confidence intervals</subject><subject>Defibrillators, Implantable</subject><subject>device upgrade</subject><subject>Diastole</subject><subject>Drug therapy</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hard disks</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Heart Failure - therapy</subject><subject>Humans</subject><subject>implantable cardioverter-defibrillator</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Patients</subject><subject>Quality of Life</subject><subject>Questioning</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>remodeling</subject><subject>Stroke Volume</subject><subject>Systole</subject><subject>Tachycardia, Ventricular - prevention & control</subject><subject>Ultrasonic imaging</subject><subject>ventricular arrhythmias</subject><subject>Ventricular Dysfunction, Left - therapy</subject><subject>Ventricular Fibrillation - prevention & control</subject><subject>Ventricular Remodeling</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kt-K1DAUxoso7jj6Al5IQMSrjknatAmIsIx_dmFQ0V33MqTpqc3YNvWkMzC-lK9oyowu7IVXB8Lv-3LO-U6SPGV0xSgrXm1XW2PtilPGVlSuaCbvJQsmhEwzocr7yYKWmUgZVeVZ8iiELaW0kEw9TM44pyoTNF8kvy_7sTPDZKoOyNpg7fwecAJM30LjKnRdZyaP5LOZHAxTIDetJ-cI5Hr8jqaGmpihJl8gjD7WyR89jJ2fDoNt0Q_uV9T6gVy1gGY8kAuzB7KBEMi36IjO7jqD0RPbw9T2zgSy9v1oMHrfuKklH_2AR3_A8Dh50JguwJNTXSbX799drS_SzacPl-vzTWoF41NqCluJvJJ1zQXPeCVMJUvF87xUTDWM1TVrBFdNUSlV8sLKihW8lDwzZSNYmWfL5OXRd0T_cwdh0r0LFuI2BvC7oBUVRSlkLiL5_A659TscYnOaCZZLoQo5U_xIWfQhIDR6RNcbPGhG9Zym3uo5TT2nqanUMc0oenay3lU91P8kf-OLwIsTYII1XYNmsC7ccoILQeMClsnrIwdxZXsHqIONcVqoHYKddO3d__t4c0duOze4-OMPOEC4nVcHrqn-Ot_dfHaM0YxzybI_tJ_UoQ</recordid><startdate>20111122</startdate><enddate>20111122</enddate><creator>Thijssen, Joep, MD</creator><creator>Borleffs, C. Jan Willem, MD, PhD</creator><creator>Delgado, Victoria, MD, PhD</creator><creator>van Rees, Johannes B., MD</creator><creator>Mooyaart, Eline A.Q., MD</creator><creator>van Bommel, Rutger J., MD</creator><creator>van Erven, Lieselot, MD, PhD</creator><creator>Boersma, Eric, PhD</creator><creator>Bax, Jeroen J., MD, PhD</creator><creator>Schalij, Martin J., MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20111122</creationdate><title>Implantable Cardioverter-Defibrillator Patients Who Are Upgraded and Respond to Cardiac Resynchronization Therapy Have Less Ventricular Arrhythmias Compared With Nonresponders</title><author>Thijssen, Joep, MD ; Borleffs, C. Jan Willem, MD, PhD ; Delgado, Victoria, MD, PhD ; van Rees, Johannes B., MD ; Mooyaart, Eline A.Q., MD ; van Bommel, Rutger J., MD ; van Erven, Lieselot, MD, PhD ; Boersma, Eric, PhD ; Bax, Jeroen J., MD, PhD ; Schalij, Martin J., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c512t-a6cb54b8dd25232b5ab8792447919f11dd1f529f6b99726c8b1627823a7f51743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiac Resynchronization Therapy</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiomyopathy</topic><topic>Cardiovascular</topic><topic>Confidence intervals</topic><topic>Defibrillators, Implantable</topic><topic>device upgrade</topic><topic>Diastole</topic><topic>Drug therapy</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hard disks</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Heart Failure - therapy</topic><topic>Humans</topic><topic>implantable cardioverter-defibrillator</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Patients</topic><topic>Quality of Life</topic><topic>Questioning</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>remodeling</topic><topic>Stroke Volume</topic><topic>Systole</topic><topic>Tachycardia, Ventricular - prevention & control</topic><topic>Ultrasonic imaging</topic><topic>ventricular arrhythmias</topic><topic>Ventricular Dysfunction, Left - therapy</topic><topic>Ventricular Fibrillation - prevention & control</topic><topic>Ventricular Remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thijssen, Joep, MD</creatorcontrib><creatorcontrib>Borleffs, C. Jan Willem, MD, PhD</creatorcontrib><creatorcontrib>Delgado, Victoria, MD, PhD</creatorcontrib><creatorcontrib>van Rees, Johannes B., MD</creatorcontrib><creatorcontrib>Mooyaart, Eline A.Q., MD</creatorcontrib><creatorcontrib>van Bommel, Rutger J., MD</creatorcontrib><creatorcontrib>van Erven, Lieselot, MD, PhD</creatorcontrib><creatorcontrib>Boersma, Eric, PhD</creatorcontrib><creatorcontrib>Bax, Jeroen J., MD, PhD</creatorcontrib><creatorcontrib>Schalij, Martin J., MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thijssen, Joep, MD</au><au>Borleffs, C. Jan Willem, MD, PhD</au><au>Delgado, Victoria, MD, PhD</au><au>van Rees, Johannes B., MD</au><au>Mooyaart, Eline A.Q., MD</au><au>van Bommel, Rutger J., MD</au><au>van Erven, Lieselot, MD, PhD</au><au>Boersma, Eric, PhD</au><au>Bax, Jeroen J., MD, PhD</au><au>Schalij, Martin J., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implantable Cardioverter-Defibrillator Patients Who Are Upgraded and Respond to Cardiac Resynchronization Therapy Have Less Ventricular Arrhythmias Compared With Nonresponders</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2011-11-22</date><risdate>2011</risdate><volume>58</volume><issue>22</issue><spage>2282</spage><epage>2289</epage><pages>2282-2289</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives The purpose of this study was to evaluate the impact of upgrading implantable cardioverter-defibrillator (ICD) therapy to cardiac resynchronization therapy (CRT) combined with defibrillator (CRT-D) on the occurrence of ventricular arrhythmia (VA) and appropriate ICD therapies. Background CRT has been shown to improve left ventricular (LV) systolic function and induce reverse LV remodeling. In addition, it has been hypothesized that CRT may reduce the incidence of VA. Methods Heart failure patients receiving an upgrade from ICD to CRT-D were evaluated. Patients were considered responders to CRT if LV end-systolic volume reduced ≥15% at 6 months of follow-up. Episodes of VA, triggering device therapy (anti-tachycardia pacing and shocks) were recorded before and after upgrade for the overall population. In addition, these outcomes were compared between CRT responders and nonresponders during the follow-up period after CRT response was assessed. Results One hundred fifteen patients (93 males [81%], age 65 ± 12 years) were evaluated during a mean follow-up of 54 ± 34 months before CRT-D upgrade and 37 ± 27 months after upgrade. In CRT responders (n = 70), the frequency of VA requiring appropriate device therapy demonstrated a trend toward a decrease from 0.51 ± 0.79 to 0.30 ± 0.59 per patient per year after CRT-D upgrade (p = 0.052). In CRT nonresponders (n = 45), the frequency of VA requiring appropriate device therapy significantly increased from 0.40 ± 0.69 to 1.21 ± 2.53 per patient per year after CRT-D upgrade (p = 0.014). Conclusions After upgrade from ICD to CRT-D, nonresponders to CRT showed a significant increase in VA burden requiring appropriate device therapy.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22093504</pmid><doi>10.1016/j.jacc.2011.08.038</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biological and medical sciences Cardiac arrhythmia Cardiac dysrhythmias Cardiac Resynchronization Therapy Cardiology Cardiology. Vascular system Cardiomyopathy Cardiovascular Confidence intervals Defibrillators, Implantable device upgrade Diastole Drug therapy Echocardiography Female Follow-Up Studies Hard disks Heart Heart attacks Heart failure Heart Failure - therapy Humans implantable cardioverter-defibrillator Internal Medicine Male Medical sciences Mortality Multivariate Analysis Patients Quality of Life Questioning Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) remodeling Stroke Volume Systole Tachycardia, Ventricular - prevention & control Ultrasonic imaging ventricular arrhythmias Ventricular Dysfunction, Left - therapy Ventricular Fibrillation - prevention & control Ventricular Remodeling |
| title | Implantable Cardioverter-Defibrillator Patients Who Are Upgraded and Respond to Cardiac Resynchronization Therapy Have Less Ventricular Arrhythmias Compared With Nonresponders |
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