Cardiac resynchronization therapy follow-up study

Long-term survival following upgrade compared with de novo cardiac resynchronization therapy implantation: a single-centre, high-volume experience

Cardiac resynchronization therapy (CRT) is an effective treatment in symptomatic heart failure (HF) patients. The study compared the results of two groups of patients undergoing CRT procedures. “De novo” patients received their first implanted devices, while the second group consisted of patients whose previously implanted devices (pacemakers, cardioverter-defibrillators) got updated to a CRT device. Regarding the baseline clinical characteristics, upgrade patients were significantly older, suffered more frequently from other diseases compared to de novo patients. Females were less common in the upgrade patient group. 

“During the median follow-up time of 3.7 years we demonstrated a 41% higher risk of mortality in upgrade compared to de novo patients. Further analysis has found that the “upgrade” intervention is not an independent predictor of mortality. The higher mortality rates in the upgrade group may be attributable to the higher comorbidity burden of upgrade patients. The rate of peri- and post-procedural complications (i.e. lead dysfunction and pocket infections) was higher among upgrade patients than in the de novo group,” – added Walter Richárd Schwertner, student of the Doctoral School of Theoretical and Translational Medicine.