Renal Dysfunction, Recovery Time Dispersion and Ventricular Arrhythmias in Heart Failure Patients Receiving Cardiac Resynchronization Therapy Defibrillator

Abstract

Introduction: The aim of this study is to evaluate the influence of renal dysfunction and recovery time dispersion on the occurrence of arrhythmic events in HF patients receiving Cardiac resynchronization therapy (CRT)-implantable cardioverter defibrillator (ICD) devices (CRT-D) without a history of cardiac arrest or sustained ventricular tachycardia. Methods: We studied 80 HF patients who underwent CRT-D implantation from 2007 to 2010 and had indications for ICD for primary prevention of sudden cardiac death. Renal dysfunction was defined as eGFR<60 mL/min/1.73 m2. 187-ch repolarization interval-difference mapping electrocardiograph (187-ch RIDM-ECG) were performed after the implantation and the inter-lead difference between corrected T peak to T end intervals (Tp-e) were analyzed. Results: During mean follow-up time of 13±7 months, 16 patients (20%) experienced appropriate ICD therapy. There was a significantly higher incidence of appropriate ICD therapy in patients with renal dysfunction than without (35% vs. 12%, p<0.05). Among patients with renal dysfunction, there was a significantly higher inter-lead difference between Tp-e (82±30 vs 63±30 msec, p<0.05) in patients with appropriate ICD therapy than without. Conclusion: Both renal dysfunction and recovery time dispersion were associated with a higher incidence ICD therapy in HF patients receiving CRT-D.