PMID- 18952828
OWN - NLM
STAT- MEDLINE
DCOM- 20090309
LR  - 20081217
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 11
IP  - 1
DP  - 2009 Jan
TI  - Relationship between New York Heart Association class change and ventricular 
      tachyarrhythmia occurrence in patients treated with cardiac resynchronization 
      plus defibrillator.
PG  - 80-5
LID - 10.1093/europace/eun288 [doi]
AB  - AIMS: In patients with advanced heart failure (HF) and prolonged QRS interval, 
      cardiac resynchronization therapy (CRT) reduces symptoms and risk of death. The 
      added benefit of an implantable cardioverter defibrillator (ICD) remains 
      questionable in some patients. METHODS AND RESULTS: In 332 HF patients treated 
      with CRT-D (CRT with ICD) [65 +/- 10 years, 86% men, 23% New York Heart 
      Association (NYHA) class II, 65% class III, and 11% class IV, 70% primary 
      prevention, 55% ischaemic cardiomyopathy, left ventricular ejection fraction 25 
      +/- 7.5%, and QRS width 167 +/- 32 ms], we evaluated the relationship between 
      functional status change, death at 6-month follow-up (FU), and the occurrence of 
      ventricular tachyarrhythmia/ventricular fibrillation (VT/VF). A total of 68 
      patients (20.5%) experienced 1266 spontaneous episodes of VT/VF during FU. There 
      was no difference in baseline characteristics between patients with or without 
      VT/VF, except for ICD indication (primary or secondary prevention). Improvement 
      in NYHA class was significantly associated with a decreased occurrence of VT/VF 
      (P = 0.004). Sixteen patients who died had significantly more often VT/VF than 
      the survivors (50 vs. 19%, P = 0.007). CONCLUSION: Within the initial 6-month 
      post-CRT therapy, 20% of patients received an appropriate ICD therapy. Patients 
      improving on NYHA class (responders to CRT) have less VT/VF episodes than 
      non-responders. Discriminant criteria for CRT response are awaited to optimize 
      the choice of the device (CRT alone, defibrillator alone, or CRT-D).
FAU - Lepillier, Antoine
AU  - Lepillier A
AD  - Centre Cardiologique du Nord, 26 rue des Moulins Gemeaux 93200, Saint-Denis, 
      France. alepillier@hotmail.com
FAU - Piot, Olivier
AU  - Piot O
FAU - Gerritse, Bart
AU  - Gerritse B
FAU - Copie, Xavier
AU  - Copie X
FAU - Lavergne, Thomas
AU  - Lavergne T
FAU - Paziaud, Olivier
AU  - Paziaud O
FAU - Lascault, Gilles
AU  - Lascault G
FAU - Waintraub, Xavier
AU  - Waintraub X
FAU - Otmani, Akli
AU  - Otmani A
FAU - Le Heuzey, Jean-Yves
AU  - Le Heuzey JY
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
DEP - 20081024
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Aged
MH  - Cardiac Pacing, Artificial/*mortality
MH  - Defibrillators, Implantable/*statistics & numerical data
MH  - Europe/epidemiology
MH  - Female
MH  - Heart Failure/*mortality/*prevention & control
MH  - Humans
MH  - Male
MH  - Prevalence
MH  - Risk Assessment/methods
MH  - Risk Factors
MH  - Statistics as Topic
MH  - Survival Analysis
MH  - Survival Rate
MH  - Tachycardia, Ventricular/*mortality/*prevention & control
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/mortality/prevention & control
EDAT- 2008/10/28 09:00
MHDA- 2009/03/10 09:00
CRDT- 2008/10/28 09:00
PHST- 2008/10/28 09:00 [entrez]
PHST- 2008/10/28 09:00 [pubmed]
PHST- 2009/03/10 09:00 [medline]
AID - eun288 [pii]
AID - 10.1093/europace/eun288 [doi]
PST - ppublish
SO  - Europace. 2009 Jan;11(1):80-5. doi: 10.1093/europace/eun288. Epub 2008 Oct 24.