217 Long-term monitoring of 340 patients with a cardiac resynchronization therapy: comparing CRT-P and CRT-D and evaluation of responders

Abstract

The main objective of this retrospective study is to analyze the future of heart failure patients, refractory to optimal pharmacological treatment, implanted by a system of bi-ventricular pacemaker (CRT-P) or defibrillator (CRT-D). 340 patients were implanted between the 1 st January 1999 and 31 December 2007, aged 69 +/-10 years mainly men (80%). The total population presented in part ischemic heart disease (56%), NYHA class III (79%) and an indication of primary prevention (76%). The number of hospitalization in the 6 months prior to implantation is an average of 1 +/-1. The population was divided into 3 groups: Group 1: 49 patients implanted with a CRT-P before March 2003 Group 2: 84 patients implanted with a CRT-P after March 2003 Group 3: 207 patients implanted with a CRT-D after March 2003. For all 3 groups combined rate of responders was 75%, with a reduction in particular, the NYHA class (p <0.001), number of hospitalizations (p <0.001) and an increasing LVEF (p <0.001). The curves of Kaplan-Meyer shows that there is a significant difference between curves CRT-P and CRT-D curve, with a survival rate higher with the CRT-D (Logrank:: Group1 vs. Group 3 p <0.01 and Group 2 vs Group 3 p<0.05). Treatment with bi-ventricular stimulation shows that 75% of patients are improved compared to the criteria usually measured. It appears that treatment with CRT-D provides a survival rate more important for a population significantly younger (66 +/-10 years).