Longer right to left ventricular activation delay at cardiac resynchronization therapy implantation is associated with improved clinical outcome in left bundle branch block patients

Annamaria Kosztin, Valentina Kutyifa, Vivien Klaudia Nagy, L. Gellér, E. Zima, Levente Molnar, Szabolcs Szilagyi, Emin Evren Ozcan, G. Széplaki, B. Merkely

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aims Data on longer right to left ventricular activation delay (RV-LV AD) predicting clinical outcome after cardiac resynchronization therapy (CRT) by left bundle branch block (LBBB) are limited. We aimed to evaluate the impact of RV-LV AD on N-terminal pro-B-type natriuretic peptide (NT-proBNP), ejection fraction (EF), and clinical outcome in patients implanted with CRT, stratified by LBBB at baseline. Methods and results Heart failure (HF) patients undergoing CRT implantation with EF ≤ 35% and QRS ≥ 120 ms were evaluated based on their RV-LV AD at implantation. Baseline and 6-month clinical parameters, EF, and NT-proBNP values were assessed. The primary endpoint was HF or death, the secondary endpoint was all-cause mortality. A total of 125 patients with CRT were studied, 62% had LBBB. During the median follow-up of 2.2 years, 44 (35%) patients had HF/death, 36 (29%) patients died. Patients with RV-LV AD ≥ 86 ms (lower quartile) had significantly lower risk of HF/death [hazard ratio (HR): 0.44; 95% confidence interval (95% CI): 0.23-0.82; P = 0.001] and all-cause mortality (HR: 0.48; 95% CI: 0.23-1.00; P = 0.05), compared with those with RV-LV AD <86 ms. Patients with RV-LV AD ≥ 86 ms and LBBB showed the greatest improvement in EF (28-36%; P

Original languageEnglish
Pages (from-to)550-559
Number of pages10
JournalEuropace
Volume18
Issue number4
DOIs
Publication statusPublished - Apr 1 2016

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Cardiac Resynchronization Therapy
Bundle-Branch Block
Heart Failure
Brain Natriuretic Peptide
Confidence Intervals
Mortality

Keywords

  • Cardiac resynchronization therapy response
  • Clinical response
  • RV-LV activation delay

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Longer right to left ventricular activation delay at cardiac resynchronization therapy implantation is associated with improved clinical outcome in left bundle branch block patients. / Kosztin, Annamaria; Kutyifa, Valentina; Nagy, Vivien Klaudia; Gellér, L.; Zima, E.; Molnar, Levente; Szilagyi, Szabolcs; Ozcan, Emin Evren; Széplaki, G.; Merkely, B.

In: Europace, Vol. 18, No. 4, 01.04.2016, p. 550-559.

Research output: Contribution to journalArticle

Kosztin, Annamaria ; Kutyifa, Valentina ; Nagy, Vivien Klaudia ; Gellér, L. ; Zima, E. ; Molnar, Levente ; Szilagyi, Szabolcs ; Ozcan, Emin Evren ; Széplaki, G. ; Merkely, B. / Longer right to left ventricular activation delay at cardiac resynchronization therapy implantation is associated with improved clinical outcome in left bundle branch block patients. In: Europace. 2016 ; Vol. 18, No. 4. pp. 550-559.
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AU - Kosztin, Annamaria

AU - Kutyifa, Valentina

AU - Nagy, Vivien Klaudia

AU - Gellér, L.

AU - Zima, E.

AU - Molnar, Levente

AU - Szilagyi, Szabolcs

AU - Ozcan, Emin Evren

AU - Széplaki, G.

AU - Merkely, B.

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N2 - Aims Data on longer right to left ventricular activation delay (RV-LV AD) predicting clinical outcome after cardiac resynchronization therapy (CRT) by left bundle branch block (LBBB) are limited. We aimed to evaluate the impact of RV-LV AD on N-terminal pro-B-type natriuretic peptide (NT-proBNP), ejection fraction (EF), and clinical outcome in patients implanted with CRT, stratified by LBBB at baseline. Methods and results Heart failure (HF) patients undergoing CRT implantation with EF ≤ 35% and QRS ≥ 120 ms were evaluated based on their RV-LV AD at implantation. Baseline and 6-month clinical parameters, EF, and NT-proBNP values were assessed. The primary endpoint was HF or death, the secondary endpoint was all-cause mortality. A total of 125 patients with CRT were studied, 62% had LBBB. During the median follow-up of 2.2 years, 44 (35%) patients had HF/death, 36 (29%) patients died. Patients with RV-LV AD ≥ 86 ms (lower quartile) had significantly lower risk of HF/death [hazard ratio (HR): 0.44; 95% confidence interval (95% CI): 0.23-0.82; P = 0.001] and all-cause mortality (HR: 0.48; 95% CI: 0.23-1.00; P = 0.05), compared with those with RV-LV AD <86 ms. Patients with RV-LV AD ≥ 86 ms and LBBB showed the greatest improvement in EF (28-36%; P

AB - Aims Data on longer right to left ventricular activation delay (RV-LV AD) predicting clinical outcome after cardiac resynchronization therapy (CRT) by left bundle branch block (LBBB) are limited. We aimed to evaluate the impact of RV-LV AD on N-terminal pro-B-type natriuretic peptide (NT-proBNP), ejection fraction (EF), and clinical outcome in patients implanted with CRT, stratified by LBBB at baseline. Methods and results Heart failure (HF) patients undergoing CRT implantation with EF ≤ 35% and QRS ≥ 120 ms were evaluated based on their RV-LV AD at implantation. Baseline and 6-month clinical parameters, EF, and NT-proBNP values were assessed. The primary endpoint was HF or death, the secondary endpoint was all-cause mortality. A total of 125 patients with CRT were studied, 62% had LBBB. During the median follow-up of 2.2 years, 44 (35%) patients had HF/death, 36 (29%) patients died. Patients with RV-LV AD ≥ 86 ms (lower quartile) had significantly lower risk of HF/death [hazard ratio (HR): 0.44; 95% confidence interval (95% CI): 0.23-0.82; P = 0.001] and all-cause mortality (HR: 0.48; 95% CI: 0.23-1.00; P = 0.05), compared with those with RV-LV AD <86 ms. Patients with RV-LV AD ≥ 86 ms and LBBB showed the greatest improvement in EF (28-36%; P

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KW - Clinical response

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DO - 10.1093/europace/euv117

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