Is Cardiac Resynchronisation Therapy Proarrhythmic?
Author Information
Author(s): Francisco Leyva, Paul Foley
Primary Institution: University of Birmingham, Good Hope Hospital
Hypothesis
Does cardiac resynchronisation therapy (CRT) promote arrhythmogenesis under certain circumstances?
Conclusion
CRT may have differential effects on the arrhythmogenic substrate, being antiarrhythmic in some patients and proarrhythmic in others.
Supporting Evidence
- CRT was associated with a 36% reduction in all-cause mortality in the CARE-HF study.
- The rate of sudden cardiac death remains high in patients treated with CRT.
- 47% of patients exhibited an increase in QT dispersion following CRT.
Takeaway
Cardiac resynchronisation therapy can help some heart failure patients, but it might also cause dangerous heart rhythms in others.
Methodology
The study analyzed the effects of CRT on QT dispersion and major arrhythmic events in 75 patients over a follow-up of 807 days.
Limitations
The study did not identify specific factors that predict which patients are at risk for arrhythmias following CRT.
Participant Demographics
Patients with heart failure, NYHA class III or IV, and left ventricular ejection fraction of ≤35%.
Statistical Information
P-Value
p=0.0017
Statistical Significance
p<0.001
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