Current status of cardiac resynchronization therapy with defibrillators and factors influencing its prognosis in Japan

Akihiko Shimizu, Takeshi Mihashi, Hiroshi Furushima, Yukio Sekiguchi, Tetsuyuki Manaka, Nobuhiro Nishii, Takeshi Ueyama, Hisashi Yokoshiki, Norishige Morita, Takashi Nitta, Ken Okumura

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6 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to clarify the prognosis of cardiac resynchronization therapy with defibrillators (CRT-Ds) in Japan. Methods: We selected 384 patients implanted with a CRT-D device from the observation database (n=1482) of the Japanese Cardiac Device Therapy Registry. We investigated the CRT criteria, including the presence of New York Heart Association (NYHA) class III/IV symptoms, left ventricular ejection fraction (LVEF) ≤35%, and QRS duration≥120 ms. The patients were divided into 2 groups: the group fulfilling all of the 3 criteria (Group A, n=229) and the group not fulfilling the criteria (Group B, n=155). We compared mortality and appropriate shock rates between the 2 groups. Results: There was no significant difference in mortality (17.9% vs. 13.5%) or appropriate shock rates (32.5% vs. 31.6%) during the observation period of 29.0715.7 months between the 2 groups. A logistic multivariate analysis showed that appropriate shocks (hazard ratio [HR]=1.85) and class III antiar-rhythmic agents (HR=2.33) were independently associated with all-cause death, and that age≥70 years (HR=0.55), male gender (HR=2.07), and presence of a single-chamber device (HR=1.78) were associated with appropriate shocks. The prognosis of Group A was better than that of the COMPANION trial. Conclusions: Japanese patients with CRT-D devices had a better prognosis than did those in the COMPANION trial, but no significant differences were observed between patients fulfilling and those not fulfilling the above mentioned criteria.

Original languageEnglish
Pages (from-to)168-174
Number of pages7
Journaljournal of arrhythmia
Volume29
Issue number3
DOIs
Publication statusPublished - Jun 2013

Keywords

  • Appropriate shock
  • Cardiac resynchronization therapy with defibrillator
  • Mortality
  • Registration

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Shimizu, A., Mihashi, T., Furushima, H., Sekiguchi, Y., Manaka, T., Nishii, N., Ueyama, T., Yokoshiki, H., Morita, N., Nitta, T., & Okumura, K. (2013). Current status of cardiac resynchronization therapy with defibrillators and factors influencing its prognosis in Japan. journal of arrhythmia, 29(3), 168-174. https://doi.org/10.1016/j.joa.2013.04.006