Cardiac resynchronization therapy-defibrillator improves long-term survival compared with cardiac resynchronization therapy-pacemaker in patients with a class IA indication for cardiac resynchronization therapy: Data from the Contak Italian Registry

Giovanni Morani, Maurizio Gasparini, Francesco Zanon, Edoardo Casali, Alfredo Spotti, Albino Reggiani, Emanuele Bertaglia, Francesco Solimene, Giulio Molon, Michele Accogli, Corrado Tommasi, Alessandro Paoletti Perini, Carmine Ciardiello, Luigi Padeletti

Research output: Contribution to journalArticlepeer-review

Abstract

AimsIn candidates for cardiac resynchronization therapy (CRT), the choice between pacemaker (CRT-P) and defibrillator (CRT-D) implantation is still debated. We compared the long-term prognosis of patients who received CRT-D or CRT-P according to class IA recommendations of the European Society of Cardiology (ESC) and who were enrolled in a multicentre prospective registry.Methods and resultsA total of 620 heart failure patients underwent successful implantation of a CRT device and were enrolled in the Contak Italian Registry. This analysis included 266 patients who received a CRT-D and 108 who received a CRT-P according to class IA ESC indications. Their survival status was verified after a median follow-up of 55 months. During follow-up, 73 CRT-D and 44 CRT-P patients died (rate 6.6 vs. 10.4%/year; log-rank test, P = 0.020). Patients receiving CRT-P were predominantly older, female, had no history of life-threatening ventricular arrhythmias, and more frequently presented non-ischaemic aetiology of heart failure, longer QRS durations, and worse renal function. However, the only independent predictor of death from any cause was the use of CRT-P (hazard ratio, 1.97; 95% confidence interval, 1.21-3.16; P = 0.007).ConclusionThe implantation of CRT-D, rather than CRT-P, may be preferable in patients presenting with current class IA ESC indications for CRT. Indeed, CRT-D resulted in greater long-term survival and was independently associated with a better prognosis.

Original languageEnglish
Pages (from-to)1273-1279
Number of pages7
JournalEuropace
Volume15
Issue number9
DOIs
Publication statusPublished - Sep 2013

Keywords

  • Cardiac resynchronization therapy
  • Heart Failure
  • ICD
  • Mortality
  • Pacemaker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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