+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Temporal Influence of Heart Failure Hospitalizations Prior to Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy With Defibrillator on Subsequent Outcome in Mild Heart Failure Patients (from MADIT-CRT)



Temporal Influence of Heart Failure Hospitalizations Prior to Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy With Defibrillator on Subsequent Outcome in Mild Heart Failure Patients (from MADIT-CRT)



American Journal of Cardiology 115(10): 1423-1427



The temporal effect of heart failure (HF) hospitalization occurring at different time periods before implantation has not yet been studied in detail. The aim of the present study was to investigate the potential association between time from last HF hospitalization to device implantation and effects on subsequent outcomes and benefit from cardiac resynchronization therapy with a defibrillator (CRT-D). Multivariate Cox models were used to determine the temporal influence of previous HF hospitalization on the end point of HF or death within all left bundle branch block implantable cardioverter-defibrillator (ICD) and CRT-D patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT) trial (n = 1,250) and to evaluate the clinical benefit of CRT-D implantation, comparing CRT-D patients with ICD patients within each previous HF hospitalization group. The patients with previous HF hospitalization ≤12 months before device implantation had the greatest incidence of HF or death during 4-year follow-up (31%), while those with previous HF hospitalization >12 months and those with no previous HF hospitalization had similar lower rates of HF or death (22% and 24%, respectively). All patients treated with CRT-D derived significant clinical benefit compared with their ICD counterparts, regardless of time of previous hospitalization (hazard ratios 0.38 [no previous hospitalization], 0.49 (≤12 months), and 0.45 (>12 months); p for interaction = 0.67). In conclusion, in the present study of patients with mild HF with prolonged QRS intervals and LBBB, a previous HF hospitalization ≤12 months was associated with increased risk for HF or death compared with >12 months and no previous HF hospitalizations. The clinical benefit of CRT-D was evident in all patients regardless of time from last HF hospitalization to implantation compared with ICD only.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058981712

Download citation: RISBibTeXText

PMID: 25817576

DOI: 10.1016/j.amjcard.2015.02.029


Related references

The effect of intermittent atrial tachyarrhythmia on heart failure or death in cardiac resynchronization therapy with defibrillator versus implantable cardioverter-defibrillator patients: a MADIT-CRT substudy (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy). Journal of the American College of Cardiology 63(12): 1190-1197, 2014

Yield of left ventricular dyssynchrony by gated SPECT MPI in patients with heart failure prior to implantable cardioverter-defibrillator or cardiac resynchronization therapy with a defibrillator: Characteristics and prediction of cardiac outcome. Journal of Nuclear Cardiology 24(1): 122-129, 2015

Incidence of appropriate cardioverter-defibrillator shocks and mortality in patients with heart failure treated with combined cardiac resynchronization plus implantable cardioverter-defibrillator therapy versus implantable cardioverter-defibrillator therapy. Journal of Cardiovascular Pharmacology and Therapeutics 15(1): 37-40, 2010

Statins reduce appropriate cardioverter-defibrillator shocks and mortality in patients with heart failure and combined cardiac resynchronization and implantable cardioverter-defibrillator therapy. Journal of Cardiovascular Pharmacology and Therapeutics 14(3): 176-179, 2009

Cost-Effectiveness of Adding Cardiac Resynchronization Therapy to an Implantable Cardioverter-Defibrillator Among Patients With Mild Heart Failure. Annals of Internal Medicine 163(6): 417-426, 2015

Incidence Of Appropriate Cardioverter-Defibrillator Shocks And Of Mortality In Patients With Heart Failure Treated With Combined Cardiac Resynchronization Plus Cardioverter-Defibrillator Therapy Versus Cardioverter-Defibrillator Therapy. Chest 136(4): 100S-1-100S-2, 2009

CRT plus ICD in congestive heart failure. Use of cardiac resynchronization therapy and an implantable cardioverter-defibrillator in heart failure patients with abnormal left ventricular dysfunction. Geriatrics 60(2): 24, 26-8, 2005

Utility of the Seattle Heart Failure Model in patients with cardiac resynchronization therapy and implantable cardioverter defibrillator referred for heart transplantation. American Heart Journal 168(3): 325-331, 2014

Comparison of Long-Term Survival Benefits With Cardiac Resynchronization Therapy in Patients With Mild Heart Failure With Versus Without Diabetes Mellitus (from the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy [MADIT-CRT]). American Journal of Cardiology 121(12): 1567-1574, 2018

Diabetes Mellitus and Outcomes of Cardiac Resynchronization With Implantable Cardioverter-Defibrillator Therapy in Older Patients With Heart Failure. Circulation. Arrhythmia and Electrophysiology 9(8), 2017

Update of implantable cardioverter/defibrillator and cardiac resynchronization therapy in heart failure. Current Opinion in Cardiology 19(3): 264-269, 2004

Effect of cardiac resynchronization therapy with implantable cardioverter defibrillator versus cardiac resynchronization therapy with pacemaker on mortality in heart failure patients: results of a high-volume, single-centre experience. European Journal of Heart Failure 16(12): 1323-1330, 2015

Cardiac Resynchronization Therapy Reduces Ventricular Arrhythmias in Primary but Not Secondary Prophylactic Implantable Cardioverter Defibrillator Patients: Insight From the Resynchronization in Ambulatory Heart Failure Trial. Circulation. Arrhythmia and Electrophysiology 10(3), 2017

Effect of cardiac resynchronization therapy and implantable cardioverter defibrillator on quality of life in patients with heart failure: a meta-analysis. Europace 14(11): 1602-1607, 2013

Reverse remodeling after cardiac resynchronization therapy and analysis of effect in heart failure patients with or without an indication for implantable cardioverter defibrillator. Journal of the American College of Cardiology 43(5 Suppl. A): 237A, March 3, 2004