PMID- 31515942
OWN - NLM
STAT- MEDLINE
DCOM- 20201013
LR  - 20201013
IS  - 1540-8167 (Electronic)
IS  - 1045-3873 (Linking)
VI  - 30
IP  - 11
DP  - 2019 Nov
TI  - Cardiac devices in patients with transthyretin amyloidosis: Impact on functional 
      class, left ventricular function, mitral regurgitation, and mortality.
PG  - 2427-2432
LID - 10.1111/jce.14180 [doi]
AB  - BACKGROUND: The aim of our study was to investigate outcomes of patients with 
      ATTR (amyloidosis and transthyretin) CA (cardiac amyloidosis) and implantable 
      devices with respect to left ventricular ejection fraction (LVEF), mitral 
      regurgitation (MR), New York Heart Association (NYHA) functional class, and 
      mortality. METHODS: This was a retrospective observational cohort study of 78 
      patients with ATTR CA and implantable devices. During a mean follow-up of 42 
      months we investigated the impact of right ventricular (RV) pacing burden and 
      biventricular (BiV) pacing on LVEF, MR severity, NYHA functional class, and 
      mortality. RESULTS: Worsening MR occurred in 11% of patients with a RV pacing % 
      <40% compared to 62% of those with a RV pacing burden >40% (P = .002). Similarly, 
      worsening LVEF occurred in 26% of patients who were RV paced <40% and 89% of 
      those who were RV paced >40% of the time (P < .0001) and worsening in NYHA 
      functional class occurred in 22% and 89%, respectively (P < .0001). Improvement 
      in LVEF, NYHA functional class, and MR severity occurred in 78%, 67%, and 67%, 
      respectively, in those with BiV devices. Death occurred in 67% of patients in the 
      cardiac resynchronization therapy group compared to 68% of those with a RV pacing 
      burden <40% and 92% of those with a RV pacing burden >40%. CONCLUSION: A higher 
      RV pacing burden is associated with deleterious remodeling and congestive heart 
      failure in patients with ATTR CA, whereas BiV pacing is associated with 
      improvements in LVEF, NYHA class, and degree of MR. BiV pacing should be 
      considered in patients with ATTR CA and an indication for pacing. However, 
      further larger prospective studies will need to be performed.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Donnellan, Eoin
AU  - Donnellan E
AUID- ORCID: 0000-0002-2878-9061
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Wazni, Oussama M
AU  - Wazni OM
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Saliba, Walid I
AU  - Saliba WI
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Baranowski, Bryan
AU  - Baranowski B
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Hanna, Mazen
AU  - Hanna M
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Martyn, Michael
AU  - Martyn M
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Patel, Divyang
AU  - Patel D
AUID- ORCID: 0000-0002-4274-6180
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Trulock, Kevin
AU  - Trulock K
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Menon, Venu
AU  - Menon V
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Hussein, Ayman
AU  - Hussein A
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Aagaard, Philip
AU  - Aagaard P
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Jaber, Wael
AU  - Jaber W
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Kanj, Mohamed
AU  - Kanj M
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20190925
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
RN  - Amyloidosis, Hereditary, Transthyretin-Related
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Amyloid Neuropathies, Familial/complications/mortality/physiopathology/*therapy
MH  - *Cardiac Pacing, Artificial/adverse effects/mortality
MH  - Cardiac Resynchronization Therapy
MH  - Cardiac Resynchronization Therapy Devices
MH  - Cardiomyopathies/complications/mortality/physiopathology/*therapy
MH  - Clinical Decision-Making
MH  - Databases, Factual
MH  - Disease Progression
MH  - Female
MH  - Heart Failure/etiology/mortality/physiopathology
MH  - *Hemodynamics
MH  - Humans
MH  - Male
MH  - Mitral Valve/*physiopathology
MH  - Mitral Valve Insufficiency/etiology/mortality/*physiopathology
MH  - *Pacemaker, Artificial
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Ventricular Function, Left
MH  - Ventricular Function, Right
OTO - NOTNLM
OT  - biventricular pacing
OT  - cardiac amyloidosis
OT  - cardiac devices
OT  - device therapies
OT  - heart failure
EDAT- 2019/09/14 06:00
MHDA- 2020/10/21 06:00
CRDT- 2019/09/14 06:00
PHST- 2019/07/17 00:00 [received]
PHST- 2019/09/05 00:00 [revised]
PHST- 2019/09/07 00:00 [accepted]
PHST- 2019/09/14 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
PHST- 2019/09/14 06:00 [entrez]
AID - 10.1111/jce.14180 [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2019 Nov;30(11):2427-2432. doi: 10.1111/jce.14180. 
      Epub 2019 Sep 25.