Abstract 16148: The Impact of Response to Cardiac Resynchronization Therapy on Ventricular Arrhythmic Events in CUBIC Registry
Background: It's well known that cardiac resynchronization therapy (CRT) is effective to reduce heart failure hospitalization and prolong survival. However, the impact of response to CRT on ventricular arrhythmic events (VAE) is not well established.
Methods: We investigated 436 patients without history of VAE, who could obtain pre and 6-month echo data, from CUBIC study which is a Japanese multi-center CRT registry. (age 70+/-11years, NYHA class 2.9+/-0.6, female gender 32%, ischemic heart disease 29%, LVEF 28+/-10%, LVEDD 62+/-9mm, QRS duration 151+/-37ms, CRT-D 54%) and divided into two groups, 262 (60%) CRT responders (R-group) and 174 (40%) CRT non-responders (NR group). CRT responder was defined as reduction of LVESV was < or = 15% at 6-month.
Results: After mean follow up 26+/14 months, survival rate, event free survival rate from heart failure hospitalization and event free survival rate from combined death and heart failure hospitalization were all significantly higher in R group compared to NR group (95% vs. 78% at 2-year, Log-rank p<0.0001, 83% vs. 59% at 2-year, Log-rank p<0.0001, 81% vs. 53% at 2-year, Log-rank p<0.0001, respectively). Furthermore, event free survival rate from combined VT, VF, appropriate ICD therapy for VT or VF, and sudden cardiac death was also significantly higher in R group compared to NR group (90% vs. 81% at 2-year, Log-rank p=0.008). (see figure).
Conclusion: Response to CRT seems not only to reduce heart failure events or prolong survival, but also to prevent VAE.
- © 2011 by American Heart Association, Inc.