Title : Cardiac resynchronization: Clinical and echographic study
Abstract:
Background:
Cardiac resynchronization therapy (CRT) is indicated in refractory heart failure patients, with reduced left ventricule ejection fraction (LVEF) and wide QRS, despite optimal medical treatment. The aim of this trial, was to describe baseline characteristics of our study population and the mid and long term outcome after cardiac resynchronization.
Methods:
This was a retrospective study including 50 heart failure patients who had undergone CRT from 2010 to 2016 in Mongi Slim Hospital, Tunis. Patients underwent clinical evaluation, electrocardiogram, chest radiography and echocardiography before and after CRT.
Results:
The mean age of the population was 62.14. 70 % were followed up for non ischemic cardiomyopathy. NYHA functional class was III-IV in 88 %. Rythm was sinusal in 78 %. Left bundle branch was in 74 %. The mean QRS duration was 153 ms. Improvement in NYHA class was in 75 %. Narrow QRS were obtained in 82 %. LVEF improved from 25 % to 34.6% (p=0.0001) and the left ventricule end systolic diameter from 64.57 mm to 58.12 mm (p=0.0001). Good response rate was 57.7% and super response rate was 20%. Death rate was 20%. Late complications rate was 4 %. Predictors of good response to CRT were: female sex, non ischemic cardiomyopathy, QRS duration ≥150ms, left bundle branch and supra ventricular arrhythmia free survival. Predictors of super response to CRT were: LVEF ≥ 25 % and moderate dilatation of left ventricule.
Conclusion:
Our results have shown similar results to those in the literature regarding benefits of CRT on functional status, ventricular remodeling and improvement of LVEF.
