Heart failure & cardiomyopathies

Global constructive work is associated with ventricular arrhythmias after cardiac resynchronization therapy

Eur Heart J Cardiovasc ImagingPublished Cohort study

Authors' conclusion

In patients treated with CRT-D, a GCW below median level was associated with a five-fold increase in the risk of ventricular arrhythmias.

Study context

Population
Patients on guideline-recommended treatment with a cardiac resynchronization therapy (CRT) defibrillator (CRT defibrillator (CRT-D)), assessed by 2D speckle-tracking echocardiography ≥6 months after implantation
Participants
162 patients
Exposure
Below-median vs above-median global constructive work
Outcome
Composite of:
  • Appropriate defibrillator therapy
  • Sustained ventricular arrhythmia under the monitor zone
Follow-up
Median 18 months (IQR: 12-25)

Main finding

As reported in the abstract

Below-median GCW vs Above-median GCWHazard ratio (95% CI)P value
Univariate model
8.14(1.83–36.08)
P = 0.006
Adjusted for eGFR and QRS duration
4.75(1.01–22.28)
P < 0.05
Patients with primary outcome (overall)
16 (10%)

Observational data: associations, not effects.

Original publication

Global constructive work is associated with ventricular arrhythmias after cardiac resynchronization therapy. Eur Heart J Cardiovasc Imaging. Published 25 July 2023. doi:10.1093/ehjci/jead180

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