PMID- 21913946
OWN - NLM
STAT- MEDLINE
DCOM- 20120424
LR  - 20120201
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 34
IP  - 11
DP  - 2011 Nov
TI  - Long term effects of cardiac resynchronization therapy in non-ambulatory NYHA IV 
      heart failure patients.
PG  - 1553-60
LID - 10.1111/j.1540-8159.2011.03205.x [doi]
AB  - BACKGROUND: We aimed at evaluating the long-term effects of cardiac 
      resynchronization therapy (CRT) in nonambulatory New York Heart Association 
      (NYHA) IV heart failure patients (NAIVHFP). METHODS: Eighteen patients, 15 men 
      and three women, eight with ischemic and 10 with nonischemic cardiomyopathy, who 
      underwent biventricular pacemaker implantation while they were in nonambulatory 
      NYHA IV class, were studied. Patients' age was 58 +/- 9 years and left ventricular 
      ejection fraction (LVEF) 18 +/- 3%. Follow-up data were obtained through review of 
      follow-up visits notes, stored echocardiographic studies, device interrogation 
      data, and death certificates. RESULTS: After a mean duration of 1223 +/- 846 days, 
      11 patients were alive, including five patients who underwent heart 
      transplantation (OCT) and seven dead. Three of 11 patients who received a 
      CRT-defibrillator, experienced at least one appropriate discharge, but eventually 
      they either died or received an OCT during follow-up. Sustained improvements in 
      NYHA class (Z = 2.4, P = 0.015) and 6-minute walk distance (0 vs 212 +/- 95 m, P 
      0.001) were documented after a median duration of 855 days postimplantation. 
      Cumulative proportion of death or OCT at 18 months-when full follow-up data were 
      available-was 18%, which compared favorably with historical controls. Full 
      echocardiographic and clinical follow-up data at 12-months postimplantation were 
      available for 10 patients, documenting a significant reduction in end-systolic 
      volume (248 +/- 82 vs 269 +/- 97 mL, P = 0.039). CONCLUSIONS: CRT can be safely 
      applied in this subset of extreme severity heart failure patients, achieving 
      encouraging survival rates and reverse remodeling effects. These observations can 
      form an evidence-based rationale for including NAIVHFP in randomized CRT trials.
FAU - Theodorakis, George
AU  - Theodorakis G
AD  - Henry Dynant Hospital, Athens, Greece.
FAU - Katsikis, Athanasios
AU  - Katsikis A
FAU - Livanis, Efthimios
AU  - Livanis E
FAU - Kostopoulou, Anna
AU  - Kostopoulou A
FAU - Adamopoulos, Stamatis
AU  - Adamopoulos S
FAU - Tsiapras, Dimitrios
AU  - Tsiapras D
FAU - Voudris, Vassilis
AU  - Voudris V
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Cardiac Resynchronization Therapy/*mortality/statistics & numerical data
MH  - Female
MH  - Greece/epidemiology
MH  - Heart Failure/*mortality/*prevention & control
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Prevalence
MH  - Risk Assessment
MH  - Survival Analysis
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2011/09/15 06:00
MHDA- 2012/04/25 06:00
CRDT- 2011/09/15 06:00
PHST- 2011/09/15 06:00 [entrez]
PHST- 2011/09/15 06:00 [pubmed]
PHST- 2012/04/25 06:00 [medline]
AID - 10.1111/j.1540-8159.2011.03205.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2011 Nov;34(11):1553-60. doi: 
      10.1111/j.1540-8159.2011.03205.x.