Mid-term Follow-up Outcome Of Cardiac Resynchronization Therapy In Patients With Chronic Heart Failure

ObjectiveTo observe the outcome of cardiac resynchronization therapy (CRT) in patients with chronic heart failure (CHF) and explore the potential factors to improve it.MethodsFifty-six patients with class I indications for CRT received CRT or CRT-D. Clinical and echocardiographic date were regularly collected at baseline and at1,3,6,12,18,and24months post resynchronization therapy and also emergency follow-up was conducted when unexpected events were encountered. Programmed proper rate and timing of the pacing interval and drugs were adjusted according to cardiac function at each visit.ResultsTwo cases suffered sudden cardiac death,2cases showed deterioration of cardiac function and the remaining52cases showed significant improvement in cardiac function compared to baseline(LVEF:30.40±4.03vs36.40±4.72), with a total effective rate of92.9%. Atrial flutter/atrial fibrillation were recorded in16cases,9 patients developed persistent atrial fibrillation. Ventricular arrhythmias occurred in6patients,8times in total including2sudden deaths. Four times in2patients identified by CRT-D received therapy of electrical defibrillation, Two times in2patients of which had sustained ventricular tachycardia treated immediately after admission, and the administration of amiodarone was effective.ConclusionsCRT is an effective treatment for patients with CHF. Persistent atrial fibrillation can reduce CRT effectiveness. CRT-D can further decreased the readmission rate and mortality rate.