The Impact of Cardiac Resynchronization Therapy on the Frequency of Ventricular Arrhythmias

A. Budzikowski, O. Hai, A. Beck, A. Khodak, C. Mitre
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Abstract

Background: Cardiac resynchronization therapy (CRT) has a proven role in improving mortality in patients with heart failure and ventricular dyssynchrony. However, the effects of biventricular pacing (CRT) on ventricular arrhythmia susceptibility have not been definitely established, and data regarding the risk of ventricular arrhythmias (VA) with CRT has been limited and conflicting.The aim of this study was to compare the burden of VA in the short term before and after an upgrade to a cardiac resynchronization device in order to avoid the long term effects of myocardial remodeling.Methods: We analyzed 44 consecutive patients with severe LV systolic dysfunction who underwent an upgrade from a single chamber defibrillator to biventricular defibrillator due to worsening heart failure status.Results: CRT was associated with a decrease in VA in patients with high arrhythmic burden, in women and in patients older than 65.Conclusion: In this study we provide convincing evidence that in patients with identical electrophysiological substrate, biventricular pacing alone is associated with a decrease in VA burden.
心脏再同步化治疗对室性心律失常频率的影响
背景:心脏再同步化治疗(CRT)已被证实在改善心力衰竭和心室非同步化患者的死亡率方面发挥作用。然而,双室起搏(CRT)对室性心律失常易感性的影响尚未明确确立,有关使用CRT的室性心律失常(VA)风险的数据有限且相互矛盾。本研究的目的是比较升级到心脏再同步装置前后的短期VA负担,以避免心肌重构的长期影响。方法:我们分析了44例连续的严重左室收缩功能障碍患者,由于心力衰竭恶化,他们从单室除颤器升级到双室除颤器。结果:CRT与高心律失常负担患者、女性和65岁以上患者的VA降低有关。结论:在本研究中,我们提供了令人信服的证据,证明在具有相同电生理底物的患者中,单独双室起搏与降低心室负荷有关。
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