Heart failure & cardiomyopathies
Incidences and Clinical Outcomes of Patients with a Single or Dual Chamber Implantable Cardioverter-Defibrillator Developing an Indication for Cardiac Resynchronization Therapy
Authors' conclusion
One-quarter of patients implanted with an ICD who had a narrow QRS duration at the time of implantation developed an indication for CRT during a median follow-up of 6.6 years. Yet, the majority of these patients did not undergo an upgrade to CRT, underscoring potential gaps in CRT utilization.
Study context
- Population
- Patients with ischaemic or non-ischaemic cardiomyopathy and QRS duration <130 ms who underwent implantable cardioverter-defibrillator (ICD) implantation, 2010–2022
- Participants
- 517 patients
- Outcome
- Development of an indication for CRT (per contemporary ESC guidelines)
- Follow-up
- Median 6.6 years
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Patients developing a cardiac resynchronization therapy (CRT) indication
132
25.5%
Incidence of CRT indication
4.52% per year
Observational data: associations, not effects.
Further findings
Independent predictors of developing a CRT indication
| Estimate | ||
|---|---|---|
| Baseline QRS duration | HR 1.06 /ms (95% CI 1.04–1.07) | |
| Age at implant | HR 1.04 /year (95% CI 1.02–1.06) | |
| 0.512Hazard ratio (log scale) |
Upgrade to CRT among those with a CRT indication
- Actually upgraded to CRT
- 46 (34.8%)
All-cause mortality, heart transplant or assist device implant: upgrade to CRT vs CRT indication without upgrade
- Upgrade to CRT associated with lower all-cause mortality, heart transplant or assist device implant
- log-rank p = 0.002
Original publication
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