PMID- 23811840
OWN - NLM
STAT- MEDLINE
DCOM- 20141229
LR  - 20140404
IS  - 1558-2035 (Electronic)
IS  - 1558-2027 (Linking)
VI  - 15
IP  - 4
DP  - 2014 Apr
TI  - Prevalence of ventricular arrhythmias in patients with cardiac resynchronization 
      therapy without back-up ICD: a single-center experience.
PG  - 301-6
LID - 10.2459/JCM.0b013e3283638148 [doi]
AB  - AIMS: Current guidelines recommend cardiac resynchronization therapy (CRT) in 
      selected heart failure patients, but do not precisely clarify when a back-up 
      implantable cardioverter defibrillator (ICD) should be associated (CRT-D). In 
      this study we evaluate the occurrence of ventricular arrhythmias in a population 
      of patients implanted with biventricular pacemaker without a back-up ICD (CRT-P). 
      METHODS: We performed a retrospective analysis on 84 patients (55 men, mean age 
      74 +/- 7 years), implanted with a CRT-P since April 2000. Patients had in 31% an 
      underlying coronary artery disease, in 56% an idiopatic dilated cardiomyopathy 
      and in 13% a valvular disease. An upgrade to CRT-P was performed from previous 
      conventional pacemakers in 36% of cases. Baseline New York Heart Association 
      (NYHA) functional class was II in 25%, III in 63% and IV in 12%. Mean left 
      ventricular ejection fraction was 29.8 +/- 8.8% with two-dimensional echo. During 
      follow-up, occurrence of ventricular arrhythmias was assessed clinically and 
      through the pacemaker stored data at the scheduled check-up. RESULTS: During a 
      mean follow-up of 29 months (range 2-127 months), telemetry interrogation 
      revealed unsustained ventricular tachyarrhythmias in 11 of 84 patients (13.1%). 
      Only one patient experienced an episode of sustained ventricular tachycardia. An 
      upgrading to a CRT-D was performed in two patients; one of these patients died 
      suddenly 15 months after the upgrade. Death occurred in 20 of 84 patients 
      (23.8%): 15 for refractory heart failure and five for noncardiac causes. 
      CONCLUSION: Our data show that CRT-P may be well tolerated in selected patients 
      even during a long-term follow-up; and that an upgrade to CRT-D may not be enough 
      to prevent sudden death.
FAU - Bortnik, Miriam
AU  - Bortnik M
AD  - aClinica Cardiologica, AOU Maggiore della Carita, Novara bStruttura di 
      Cardiologia, Ospedale Santo Spirito, Casale Monferrato, Italy.
FAU - Degiovanni, Anna
AU  - Degiovanni A
FAU - Dell'era, Gabriele
AU  - Dell'era G
FAU - Cavallino, Chiara
AU  - Cavallino C
FAU - Occhetta, Eraldo
AU  - Occhetta E
FAU - Marino, Paolo
AU  - Marino P
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Cardiovasc Med (Hagerstown)
JT  - Journal of cardiovascular medicine (Hagerstown, Md.)
JID - 101259752
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Cause of Death
MH  - *Defibrillators, Implantable
MH  - Electrocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/epidemiology/physiopathology/*therapy
MH  - Humans
MH  - Italy/epidemiology
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Prevalence
MH  - Prognosis
MH  - Retrospective Studies
MH  - Stroke Volume/physiology
MH  - Tachycardia, Ventricular/epidemiology/*prevention & control
EDAT- 2013/07/03 06:00
MHDA- 2014/12/30 06:00
CRDT- 2013/07/02 06:00
PHST- 2013/07/02 06:00 [entrez]
PHST- 2013/07/03 06:00 [pubmed]
PHST- 2014/12/30 06:00 [medline]
AID - 10.2459/JCM.0b013e3283638148 [doi]
PST - ppublish
SO  - J Cardiovasc Med (Hagerstown). 2014 Apr;15(4):301-6. doi: 
      10.2459/JCM.0b013e3283638148.