Refining Patient Selection for CRT

Observational findings in patients with mildly symptomatic HF show independent predictors — and improved outcomes — of super response to CRT.

The MADIT-CRT study demonstrated the effectiveness of cardiac resynchronization therapy (CRT) in patients with mild heart failure (HF) symptoms (New York Heart Association class I or II) and sinus rhythm, left ventricular ejection fractions (LVEFs) of ≤30%, and QRS durations of ≥130 milliseconds (JW Cardiol Sep 1 2009). In this substudy, investigators sought to determine predictors of super response in 752 patients randomized to CRT.

Super-responders — those in the highest quartile of LVEF improvement at 12 months — exhibited a mean absolute LVEF increase of 17.5%. These patients were more likely than responders and hypo-responders to be female, to have nonischemic etiology, and to have baseline left branch bundle block (LBBB), QRS duration …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)