PMID- 34950326
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220429
IS  - 1941-6911 (Print)
IS  - 1941-6911 (Electronic)
IS  - 1941-6911 (Linking)
VI  - 13
IP  - 4
DP  - 2020 Dec
TI  - Cardiac Resynchronization Therapy in continuous flow Left Ventricular Assist 
      Device Recipients: A Systematic Review and Meta-analysis from ELECTRAM 
      Investigators.
PG  - 2441
LID - 10.4022/jafib.2441 [doi]
LID - 2441
AB  - INTRODUCTION: Whether cardiac resynchronization therapy (CRT) continues to 
      augment left ventricular remodeling in patients with the continuous-flow left 
      ventricular assist device (cf-LVAD) remains unclear. METHODS: We performed a 
      systematic review and meta-analysis of all clinical studies examining the role of 
      continued CRT in end-stage heart failure patients with cf-LVAD reporting 
      all-cause mortality, ventricular arrhythmias, and ICD shocks. Mantel-Haenszel 
      risk ratio (RR) random-effects model was used to summarize data. RESULTS: Eight 
      studies (7 retrospective and 1 randomized) with a total of 1,208 unique patients 
      met inclusion criteria. There was no difference in all-cause mortality (RR 1.08, 
      95% CI 0.86 - 1.35, p = 0.51, I2=0%), all-cause hospitalization (RR 1.01, 95% CI 
      0.76-1.34, p = 0.95, I(2)=11%), ventricular arrhythmias (RR 1.08, 95% CI 0.83 - 
      1.39, p = 0.58, I(2) =50%) and ICD shocks (RR 0.87, 95% CI 0.57 - 1.33, p = 0.52, 
      I(2) =65%) comparing CRT versus non-CRT. Subgroup analysis demonstrated 
      significant reduction in ventricular arrhythmias (RR 0.76, 95% CI 0.64 - 0.90, p 
      = 0.001) and ICD shocks (RR 0.65, 95% CI 0.44 - 0.97, p = 0.04) in "CRT on" group 
      versus "CRT off" group. CONCLUSIONS: CRT was not associated with a reduction in 
      all-cause mortality or increased risk of ventricular arrhythmias and ICD shocks 
      compared to non-CRT in cf-LVAD patients. It remains to be determined which 
      subgroup of cf-LVAD patients benefit from CRT. The findings of our study are 
      intriguing, and therefore, larger studies in a randomized prospective manner 
      should be undertaken to address this specifically.
FAU - Shah, Kuldeep
AU  - Shah K
AD  - Department of Cardiovascular Medicine, Section of Cardiac Electrophysiology, 
      Beaumont Hospital, Oakland University William Beaumont School of Medicine, Royal 
      Oak, Michigan.
FAU - Karpe, Vallabh
AU  - Karpe V
AD  - Department of Medicine, Allegheny General Hospital, Pittsburgh, PA.
FAU - K Turagam, Mohit
AU  - K Turagam M
AD  - Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New 
      York, NY.
FAU - Shah, Mahek
AU  - Shah M
AD  - Division of Cardiology, Section of Heart Failure and Transplantation Cardiology, 
      Thomas Jefferson University Hospital, Philadelphia, PA.
FAU - Natale, Andrea
AU  - Natale A
AD  - Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, TX.
FAU - Gopinathannair, Rakesh
AU  - Gopinathannair R
AD  - Kansas City Heart Rhythm Institute and Research Foundation, Kansas City, KS.
FAU - Lakkireddy, Dhanunjaya
AU  - Lakkireddy D
AD  - Kansas City Heart Rhythm Institute and Research Foundation, Kansas City, KS.
FAU - Garg, Jalaj
AU  - Garg J
AD  - Cardiac Arrhythmia Service, Medical College of Wisconsin, Milwaukee, WI.
LA  - eng
PT  - Journal Article
DEP - 20201231
PL  - United States
TA  - J Atr Fibrillation
JT  - Journal of atrial fibrillation
JID - 101514767
PMC - PMC8691299
OTO - NOTNLM
OT  - Arrhythmias
OT  - Cardiac resynchronization therapy
OT  - LVAD
EDAT- 2021/12/25 06:00
MHDA- 2021/12/25 06:01
PMCR- 2020/12/31
CRDT- 2021/12/24 05:49
PHST- 2020/07/29 00:00 [received]
PHST- 2020/08/05 00:00 [revised]
PHST- 2020/08/15 00:00 [accepted]
PHST- 2021/12/24 05:49 [entrez]
PHST- 2021/12/25 06:00 [pubmed]
PHST- 2021/12/25 06:01 [medline]
PHST- 2020/12/31 00:00 [pmc-release]
AID - 10.4022/jafib.2441 [doi]
PST - epublish
SO  - J Atr Fibrillation. 2020 Dec 31;13(4):2441. doi: 10.4022/jafib.2441. eCollection 
      2020 Dec.