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Organized by
Nanjing Heart Center
Asian Bifurcation Club (ABC)
Nanjing First Hospital, Nanjing Medical University
Co-organized by
Chinese Society of Cardiology (CSC)
Capacity Building and Continuing Education Center,National Health and Family Planning Commission (CBCEC)
American Society for Cardiovascular Angiography and Interventions (SCAI)
Asian Heart Society (AHS)
Contact Us
Registration Administration of Domestic Representatives
Hongjuan Peng :
+86-13913895477
Haimei Xu +86-13914736846
cbsnj@cbsmd.cn
Registration Administration of Overseas Representatives
Ling Lin : +86 (25) 52271398
+86-13951884596
cbs@cbsmd.cn
Management of Challenging Cases
Yingying Zhao :+86-13815408517
sub@cbsmd.cn
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210006
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Recommended Paper
Management of Acute Myocardial Infarction During the COVID-19 Pandemic
COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up
CSC Expert Consensus on Principles of Clinical Management of Patients with Severe Emergent Cardiovascular Diseases during the COVID-19 Epidemic
ACC Clinical Bulletin Focuses on Cardiac Implications of Coronavirus (COVID-19)
Congestive Heart Failure
Original Research2021 Jan 10;S1547-5271(21)00009-6.
JOURNAL：Heart Rhythm. Article Link
S Tankut, I Goldenberg, V Kutyifa et al. Keywords: cardiac resynchronization therapy; heart failure; left bundle branch block; ventricular fibrillation; ventricular tachycardia arrhythmia.
BACKGROUND - Cardiac resynchronization therapy-defibrillator (CRT-D) may reduce the incidence of first ventricular tachyarrhythmia (VTA) in patients with heart failure (HF) and left bundle-branch-block (LBBB).
OBJECTIVE - To assess the effect of CRT-D on VTA burden in LBBB patients.
METHODS - We included 1281 patients with LBBB from MADIT-CRT. VTA was defined as any treated or monitored sustained ventricular tachycardia (VT≥180 bpm) or ventricular fibrillation (VF). Life-threatening VTA was defined as VT≥200 bpm or VF. VTA recurrence was assessed using the Andersen-Gill model.
RESULTS - During a mean follow-up of 2.5 years, 964 VTA episodes occurred in 264 (21%) patients. The VTA rate per 100 person-years was significantly lower in the CRT-D group when compared with the ICD group (20 vs. 34; respectively; p<0.01). Multivariate analysis demonstrated that CRT-D treatment was associated with a 32% risk reduction for VTA recurrence (HR=0.68; 95%CI 0.57-0.82; p<0.001), 57% risk reduction for recurrent life-threatening VTA, 54% risk reduction for recurrent appropriate ICD-shocks, and a 25% risk reduction for the combined endpoint of VTA and death. The effect of CRT on VTA burden was consistent among all tested subgroups, but was more pronounced among NYHA class I patients. Landmark analysis showed that at 2 years, the cumulative probability of death subsequent to year one was highest (16%) among patients who had ≥2 VTA events during their first year.
CONCLUSION - In patients with LBBB and HF, early intervention with CRT-D reduces mortality, VTA burden, and frequency of multiple appropriate ICD shocks. VTA burden is a powerful predictor of subsequent mortality.
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