PMID- 17169128
OWN - NLM
STAT- MEDLINE
DCOM- 20070424
LR  - 20071115
IS  - 0147-8389 (Print)
IS  - 0147-8389 (Linking)
VI  - 29 Suppl 2
DP  - 2006 Dec
TI  - Long-term survival in patients treated with cardiac resynchronization therapy: a 
      3-year follow-up study from the InSync/InSync ICD Italian Registry.
PG  - S2-10
AB  - BACKGROUND: Studies reporting the long-term survival of patients treated with 
      cardiac resynchronization therapy (CRT) outside the realm of randomized 
      controlled trials are still lacking. The aim of this study was to quantify the 
      survival of patients treated with CRT in clinical practice and to investigate the 
      long-term effects of CRT on clinical status and echocardiographic parameters. 
      METHODS: The study population consisted of 317 consecutive patients with 
      implanted CRT devices from eight Italian University/Teaching Hospitals. The 
      patients were enrolled in a national observational registry and had a minimum 
      follow-up of 2 years. A visit was performed in surviving patients and mortality 
      data were obtained by hospital file review or direct telephone contact. RESULTS: 
      During the study period, 83 (26%) patients died. The rate of all-cause mortality 
      was significantly higher in ischemic than nonischemic patients (14% vs 8%, P = 
      0.002). Multivariate analysis showed that ischemic etiology (HR 1.72, CI 
      1.06-2.79; P = 0.028) and New York Heart Association (NYHA) class IV (HR 2.87, CI 
      1.24-6.64; P = 0.014) were the strongest predictors of all-cause mortality. The 
      effects of CRT persisted at long-term follow-up (for at least 2 years) in terms 
      of NYHA class improvement, increase of left ventricular ejection fraction, 
      decrease of QRS duration (all P = 0.0001), and reduction of left ventricular 
      end-diastolic and end-systolic diameters (P = 0.024 and P = 0.011, respectively). 
      CONCLUSIONS: During long-term (3 years) follow-up after CRT, total mortality rate 
      was 10%/year. The outcome of ischemic patients was worse mainly due to a higher 
      rate of death from progressive heart failure. Ischemic etiology along with NYHA 
      class IV was identified as predictors of death. Benefits of CRT in terms of 
      clinical function and echocardiographic parameters persisted at the time of 
      long-term follow-up.
FAU - Gasparini, Maurizio
AU  - Gasparini M
AD  - IRCCS Istituto Clinico Humanitas, Rozzano (Milan), Italy. 
      maurizio.gasparini@humanitas.it
FAU - Lunati, Maurizio
AU  - Lunati M
FAU - Santini, Massimo
AU  - Santini M
FAU - Tritto, Massimo
AU  - Tritto M
FAU - Curnis, Antonio
AU  - Curnis A
FAU - Bocchiardo, Mario
AU  - Bocchiardo M
FAU - Vincenti, Antonio
AU  - Vincenti A
FAU - Pistis, Gianfranco
AU  - Pistis G
FAU - Valsecchi, Sergio
AU  - Valsecchi S
FAU - Denaro, Alessandra
AU  - Denaro A
CN  - INSYNC/INSYNC ICD ITALIAN Registry Investigators
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Cardiac Pacing, Artificial/*mortality
MH  - Comorbidity
MH  - Female
MH  - Heart Failure/*mortality/*prevention & control
MH  - Humans
MH  - Italy/epidemiology
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Registries/*statistics & numerical data
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Survival Analysis
MH  - Survival Rate
MH  - Ventricular Dysfunction, Left/*mortality/*prevention & control
EDAT- 2006/12/16 09:00
MHDA- 2007/04/25 09:00
CRDT- 2006/12/16 09:00
PHST- 2006/12/16 09:00 [pubmed]
PHST- 2007/04/25 09:00 [medline]
PHST- 2006/12/16 09:00 [entrez]
AID - PACE485 [pii]
AID - 10.1111/j.1540-8159.2006.00485.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2006 Dec;29 Suppl 2:S2-10. doi: 
      10.1111/j.1540-8159.2006.00485.x.