Time-dependent risk reduction of ventricular tachyarrhythmias in cardiac resynchronization therapy patients: A MADIT-RIT sub-study

Martin Stockburger, Arthur J. Moss, Brian Olshansky, Helmut Klein, Scott McNitt, Claudio Schuger, James P. Daubert, Ilan Goldenberg, Anne Christine H Ruwald, B. Merkely, Wojciech Zareba, Valentina Kutyifa

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Aims Data on the time-dependent benefit of cardiac resynchronization therapy with defibrillator (CRT-D) compared with a dual-chamber implantable cardioverter-defibrillator (ICD) to reduce death or ventricular tachycardia (VT) or ventricular fibrillation (VF) are limited. We aimed to evaluate the time-related risk of death or sustained VT or VF in patients receiving CRT-D vs. ICD in the MADIT-RIT trial. Methods and results Kaplan-Meier survival analyses and multivariate Cox regression models were utilized to compare the incidence and the risk of death or sustained VT/VF in the CRT-D and ICD subgroups by the elapsed time after device implantation (6 months). Of the ICD (n = 742) and CRT-D (n = 757) patients enrolled, the risk of death was lower in CRT-D vs. in ICD early after device implantation [hazard ratio (HR) = 0.42, 95% confidence interval (CI): 0.17-1.03, P = 0.058] and beyond 6 months of follow-up (HR = 0.39, 95% CI: 0.21-0.73, P = 0.004), with the 6-month interaction P = 0.899. The overall risk of sustained VT/VF was reduced in CRT-D vs. ICD patients (HR = 0.73, 95% CI: 0.52-1.03, P = 0.07). However, the risk was similar in the first 6 months (HR = 1.00, 95% CI: 0.62-1.62, P = 0.988), and a lower risk emerged 6 months after CRT-D implantation (HR = 0.58, 95% CI: 0.38-0.88, P = 0.011), with the 6-month interaction P = 0.059. Conclusion The reduced mortality risk of CRT-D compared with an ICD alone began early after device implantation and was sustained during long-term follow-up; the reduced risk for ventricular tachyarrhythmias did not emerge until 6 months after device implantation. Clinical trial registration http://clinicaltrials.gov/ct2/show/NCT00947310.

Original languageEnglish
Pages (from-to)1085-1091
Number of pages7
JournalEuropace
Volume17
Issue number7
DOIs
Publication statusPublished - Jun 1 2015

Fingerprint

Cardiac Resynchronization Therapy
Defibrillators
Risk Reduction Behavior
Implantable Defibrillators
Tachycardia
Ventricular Fibrillation
Ventricular Tachycardia
Confidence Intervals
Equipment and Supplies
Kaplan-Meier Estimate
Survival Analysis
Proportional Hazards Models
Clinical Trials
Mortality
Incidence

Keywords

  • Cardiac resynchronization therapy
  • Implantable cardioverter-defibrillator
  • MADIT-RIT
  • Ventricular fibrillation
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Stockburger, M., Moss, A. J., Olshansky, B., Klein, H., McNitt, S., Schuger, C., ... Kutyifa, V. (2015). Time-dependent risk reduction of ventricular tachyarrhythmias in cardiac resynchronization therapy patients: A MADIT-RIT sub-study. Europace, 17(7), 1085-1091. https://doi.org/10.1093/europace/euv008

Time-dependent risk reduction of ventricular tachyarrhythmias in cardiac resynchronization therapy patients : A MADIT-RIT sub-study. / Stockburger, Martin; Moss, Arthur J.; Olshansky, Brian; Klein, Helmut; McNitt, Scott; Schuger, Claudio; Daubert, James P.; Goldenberg, Ilan; Ruwald, Anne Christine H; Merkely, B.; Zareba, Wojciech; Kutyifa, Valentina.

In: Europace, Vol. 17, No. 7, 01.06.2015, p. 1085-1091.

Research output: Contribution to journalArticle

Stockburger, M, Moss, AJ, Olshansky, B, Klein, H, McNitt, S, Schuger, C, Daubert, JP, Goldenberg, I, Ruwald, ACH, Merkely, B, Zareba, W & Kutyifa, V 2015, 'Time-dependent risk reduction of ventricular tachyarrhythmias in cardiac resynchronization therapy patients: A MADIT-RIT sub-study', Europace, vol. 17, no. 7, pp. 1085-1091. https://doi.org/10.1093/europace/euv008
Stockburger, Martin ; Moss, Arthur J. ; Olshansky, Brian ; Klein, Helmut ; McNitt, Scott ; Schuger, Claudio ; Daubert, James P. ; Goldenberg, Ilan ; Ruwald, Anne Christine H ; Merkely, B. ; Zareba, Wojciech ; Kutyifa, Valentina. / Time-dependent risk reduction of ventricular tachyarrhythmias in cardiac resynchronization therapy patients : A MADIT-RIT sub-study. In: Europace. 2015 ; Vol. 17, No. 7. pp. 1085-1091.
@article{9d4254c282134429800cca3ca3eed508,
title = "Time-dependent risk reduction of ventricular tachyarrhythmias in cardiac resynchronization therapy patients: A MADIT-RIT sub-study",
abstract = "Aims Data on the time-dependent benefit of cardiac resynchronization therapy with defibrillator (CRT-D) compared with a dual-chamber implantable cardioverter-defibrillator (ICD) to reduce death or ventricular tachycardia (VT) or ventricular fibrillation (VF) are limited. We aimed to evaluate the time-related risk of death or sustained VT or VF in patients receiving CRT-D vs. ICD in the MADIT-RIT trial. Methods and results Kaplan-Meier survival analyses and multivariate Cox regression models were utilized to compare the incidence and the risk of death or sustained VT/VF in the CRT-D and ICD subgroups by the elapsed time after device implantation (6 months). Of the ICD (n = 742) and CRT-D (n = 757) patients enrolled, the risk of death was lower in CRT-D vs. in ICD early after device implantation [hazard ratio (HR) = 0.42, 95{\%} confidence interval (CI): 0.17-1.03, P = 0.058] and beyond 6 months of follow-up (HR = 0.39, 95{\%} CI: 0.21-0.73, P = 0.004), with the 6-month interaction P = 0.899. The overall risk of sustained VT/VF was reduced in CRT-D vs. ICD patients (HR = 0.73, 95{\%} CI: 0.52-1.03, P = 0.07). However, the risk was similar in the first 6 months (HR = 1.00, 95{\%} CI: 0.62-1.62, P = 0.988), and a lower risk emerged 6 months after CRT-D implantation (HR = 0.58, 95{\%} CI: 0.38-0.88, P = 0.011), with the 6-month interaction P = 0.059. Conclusion The reduced mortality risk of CRT-D compared with an ICD alone began early after device implantation and was sustained during long-term follow-up; the reduced risk for ventricular tachyarrhythmias did not emerge until 6 months after device implantation. Clinical trial registration http://clinicaltrials.gov/ct2/show/NCT00947310.",
keywords = "Cardiac resynchronization therapy, Implantable cardioverter-defibrillator, MADIT-RIT, Ventricular fibrillation, Ventricular tachycardia",
author = "Martin Stockburger and Moss, {Arthur J.} and Brian Olshansky and Helmut Klein and Scott McNitt and Claudio Schuger and Daubert, {James P.} and Ilan Goldenberg and Ruwald, {Anne Christine H} and B. Merkely and Wojciech Zareba and Valentina Kutyifa",
year = "2015",
month = "6",
day = "1",
doi = "10.1093/europace/euv008",
language = "English",
volume = "17",
pages = "1085--1091",
journal = "Europace",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "7",

}

TY - JOUR

T1 - Time-dependent risk reduction of ventricular tachyarrhythmias in cardiac resynchronization therapy patients

T2 - A MADIT-RIT sub-study

AU - Stockburger, Martin

AU - Moss, Arthur J.

AU - Olshansky, Brian

AU - Klein, Helmut

AU - McNitt, Scott

AU - Schuger, Claudio

AU - Daubert, James P.

AU - Goldenberg, Ilan

AU - Ruwald, Anne Christine H

AU - Merkely, B.

AU - Zareba, Wojciech

AU - Kutyifa, Valentina

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Aims Data on the time-dependent benefit of cardiac resynchronization therapy with defibrillator (CRT-D) compared with a dual-chamber implantable cardioverter-defibrillator (ICD) to reduce death or ventricular tachycardia (VT) or ventricular fibrillation (VF) are limited. We aimed to evaluate the time-related risk of death or sustained VT or VF in patients receiving CRT-D vs. ICD in the MADIT-RIT trial. Methods and results Kaplan-Meier survival analyses and multivariate Cox regression models were utilized to compare the incidence and the risk of death or sustained VT/VF in the CRT-D and ICD subgroups by the elapsed time after device implantation (6 months). Of the ICD (n = 742) and CRT-D (n = 757) patients enrolled, the risk of death was lower in CRT-D vs. in ICD early after device implantation [hazard ratio (HR) = 0.42, 95% confidence interval (CI): 0.17-1.03, P = 0.058] and beyond 6 months of follow-up (HR = 0.39, 95% CI: 0.21-0.73, P = 0.004), with the 6-month interaction P = 0.899. The overall risk of sustained VT/VF was reduced in CRT-D vs. ICD patients (HR = 0.73, 95% CI: 0.52-1.03, P = 0.07). However, the risk was similar in the first 6 months (HR = 1.00, 95% CI: 0.62-1.62, P = 0.988), and a lower risk emerged 6 months after CRT-D implantation (HR = 0.58, 95% CI: 0.38-0.88, P = 0.011), with the 6-month interaction P = 0.059. Conclusion The reduced mortality risk of CRT-D compared with an ICD alone began early after device implantation and was sustained during long-term follow-up; the reduced risk for ventricular tachyarrhythmias did not emerge until 6 months after device implantation. Clinical trial registration http://clinicaltrials.gov/ct2/show/NCT00947310.

AB - Aims Data on the time-dependent benefit of cardiac resynchronization therapy with defibrillator (CRT-D) compared with a dual-chamber implantable cardioverter-defibrillator (ICD) to reduce death or ventricular tachycardia (VT) or ventricular fibrillation (VF) are limited. We aimed to evaluate the time-related risk of death or sustained VT or VF in patients receiving CRT-D vs. ICD in the MADIT-RIT trial. Methods and results Kaplan-Meier survival analyses and multivariate Cox regression models were utilized to compare the incidence and the risk of death or sustained VT/VF in the CRT-D and ICD subgroups by the elapsed time after device implantation (6 months). Of the ICD (n = 742) and CRT-D (n = 757) patients enrolled, the risk of death was lower in CRT-D vs. in ICD early after device implantation [hazard ratio (HR) = 0.42, 95% confidence interval (CI): 0.17-1.03, P = 0.058] and beyond 6 months of follow-up (HR = 0.39, 95% CI: 0.21-0.73, P = 0.004), with the 6-month interaction P = 0.899. The overall risk of sustained VT/VF was reduced in CRT-D vs. ICD patients (HR = 0.73, 95% CI: 0.52-1.03, P = 0.07). However, the risk was similar in the first 6 months (HR = 1.00, 95% CI: 0.62-1.62, P = 0.988), and a lower risk emerged 6 months after CRT-D implantation (HR = 0.58, 95% CI: 0.38-0.88, P = 0.011), with the 6-month interaction P = 0.059. Conclusion The reduced mortality risk of CRT-D compared with an ICD alone began early after device implantation and was sustained during long-term follow-up; the reduced risk for ventricular tachyarrhythmias did not emerge until 6 months after device implantation. Clinical trial registration http://clinicaltrials.gov/ct2/show/NCT00947310.

KW - Cardiac resynchronization therapy

KW - Implantable cardioverter-defibrillator

KW - MADIT-RIT

KW - Ventricular fibrillation

KW - Ventricular tachycardia

UR - http://www.scopus.com/inward/record.url?scp=84936754257&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84936754257&partnerID=8YFLogxK

U2 - 10.1093/europace/euv008

DO - 10.1093/europace/euv008

M3 - Article

C2 - 25745075

AN - SCOPUS:84936754257

VL - 17

SP - 1085

EP - 1091

JO - Europace

JF - Europace

SN - 1099-5129

IS - 7

ER -