Heart failure & cardiomyopathies
Association Between a Prolonged PR Interval and Outcomes of Cardiac Resynchronization Therapy: A Report From the National Cardiovascular Data Registry
Authors' conclusion
A PR≥230 ms is associated with increased rates of heart failure hospitalization or death among CRT-D patients. The real-world comparative effectiveness of CRT-D (versus ICD) is significantly less among patients with a PR≥230 ms in comparison with patients with a PR<230 ms.
Study context
- Population
- Cardiac Resynchronization Therapy (CRT)-eligible patients (EF ≤35, QRS ≥120 ms) in the National Cardiovascular Data Registry Implantable Cardioverter Defibrillator (ICD) Registry
- Participants
- 26,451 patients
- Exposure
- PR ≥230 ms vs PR <230 ms, and CRT with defibrillator (CRT-D) vs ICD, in CRT-eligible patients
- PR≥230 msn = 4,035
- Outcome
- HF hospitalization or death
- Follow-up
- Up to 5 years
Methodological detailsinverse probability weighted, registry-based (NCDR ICD Registry with Medicare claims)
- Inverse probability weighted
- Registry-based (NCDR ICD Registry with Medicare claims)
Main finding
As reported in the abstract
HF hospitalization or death, by device type and PR interval (subgroups)
Hazard ratio (95% CI)P value
PR≥230 ms vs PR<230 msCRT-D recipients
1.23(1.14–1.31)
P < 0.001PR≥230 ms vs PR<230 msICD recipients
1.08(0.97–1.20)
P = 0.17CRT-D vs ICDPR<230 ms
0.79(0.73–0.85)
P < 0.001CRT-D vs ICDPR≥230 ms
1.01(0.87–1.17)
P = 0.90Observational data: associations, not effects.
Original publication
Association Between a Prolonged PR Interval and Outcomes of Cardiac Resynchronization Therapy: A Report From the National Cardiovascular Data Registry. Circulation. Published 19 October 2016. doi:10.
Summarised from the published abstract; every number is checked against it