Effect of echocardiography-guided left ventricular lead placement for cardiac resynchronization therapy on mortality and risk of defibrillator therapy for ventricular arrhythmias in heart failure patients (from the Speckle Tracking Assisted Resynchronization Therapy for Electrode Region [STARTER] trial).
Identifieur interne : 003315 ( Main/Merge ); précédent : 003314; suivant : 003316Effect of echocardiography-guided left ventricular lead placement for cardiac resynchronization therapy on mortality and risk of defibrillator therapy for ventricular arrhythmias in heart failure patients (from the Speckle Tracking Assisted Resynchronization Therapy for Electrode Region [STARTER] trial).
Auteurs : Evan Adelstein [États-Unis] ; Mian Bilal Alam [États-Unis] ; David Schwartzman [États-Unis] ; Sandeep Jain [États-Unis] ; Josef Marek [États-Unis] ; John Gorcsan [États-Unis] ; Samir Saba [États-Unis]Source :
- The American journal of cardiology [ 1879-1913 ] ; 2014.
Descripteurs français
- KwdFr :
- Défaillance cardiaque (), Défibrillateurs (effets indésirables), Femelle, Humains, Mâle, Méthode en double aveugle, Sujet âgé, Thérapie de resynchronisation cardiaque (), Thérapie de resynchronisation cardiaque (mortalité), Troubles du rythme cardiaque (), Ventricules cardiaques, Échocardiographie, Études de suivi, Études prospectives.
- MESH :
- effets indésirables : Défibrillateurs.
- mortalité : Thérapie de resynchronisation cardiaque.
- Défaillance cardiaque, Femelle, Humains, Mâle, Méthode en double aveugle, Sujet âgé, Thérapie de resynchronisation cardiaque, Troubles du rythme cardiaque, Ventricules cardiaques, Échocardiographie, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Aged, Arrhythmias, Cardiac (therapy), Cardiac Resynchronization Therapy (methods), Cardiac Resynchronization Therapy (mortality), Defibrillators (adverse effects), Double-Blind Method, Echocardiography, Female, Follow-Up Studies, Heart Failure (therapy), Heart Ventricles, Humans, Male, Prospective Studies.
- MESH :
- adverse effects : Defibrillators.
- methods : Cardiac Resynchronization Therapy.
- mortality : Cardiac Resynchronization Therapy.
- therapy : Arrhythmias, Cardiac, Heart Failure.
- Aged, Double-Blind Method, Echocardiography, Female, Follow-Up Studies, Heart Ventricles, Humans, Male, Prospective Studies.
Abstract
Echocardiography-guided left ventricular (LV) lead placement at the site of latest mechanical activation improves heart failure outcomes in patients receiving a cardiac resynchronization therapy defibrillator (CRT-D). In this study, we test the hypothesis that a strategy of echocardiography-guided LV lead placement improves patient survival rate free from appropriate CRT-D therapy for ventricular arrhythmias. Patients enrolled in the prospective, randomized Speckle Tracking Assisted Resynchronization Therapy for Electrode Region trial and treated with a CRT-D device (108 with the echo-guided strategy and 75 with the routine strategy) were followed to the end point of death or first appropriate CRT-D therapy. Over a follow-up period of 3.7 ± 2.1 years, 62 patients (33%) died and 40 (22%) received appropriate CRT-D therapy. Compared with the routine group, patients in the echo-guided group had improved CRT-D therapy-free survival rate (hazard ratio = 0.64, 95% confidence interval = 0.42 to 0.98, p = 0.038). Patients randomized to the echo-guided LV lead placement were more likely to resynchronize their LV compared with the routine group (72% vs 48%, respectively, p = 0.006). Patients whose LV did resynchronize after CRT-D had improved therapy-free survival rate compared with those whose LV did not resynchronize (hazard ratio = 0.49, 95% confidence interval = 0.28 to 0.86, p = 0.012). In conclusion, a strategy of echo-guided LV lead placement improved the patient survival rate free from defibrillator therapy in CRT-D recipients.
DOI: 10.1016/j.amjcard.2014.01.431
PubMed: 24630387
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type="state">Pennsylvanie</region></placeName><wicri:cityArea>Heart and Vascular Institute, Cardiology Department, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Alam, Mian Bilal" sort="Alam, Mian Bilal" uniqKey="Alam M" first="Mian Bilal" last="Alam">Mian Bilal Alam</name><affiliation wicri:level="2"><nlm:affiliation>Heart and Vascular Institute, Cardiology Department, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Heart and Vascular Institute, Cardiology Department, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Schwartzman, David" sort="Schwartzman, David" uniqKey="Schwartzman D" first="David" last="Schwartzman">David Schwartzman</name><affiliation wicri:level="2"><nlm:affiliation>Heart and 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Electronic address: sabas@upmc.edu.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Heart and Vascular Institute, Cardiology Department, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author></analytic><series><title level="j">The American journal of cardiology</title><idno type="eISSN">1879-1913</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Arrhythmias, Cardiac (therapy)</term><term>Cardiac Resynchronization Therapy (methods)</term><term>Cardiac Resynchronization Therapy (mortality)</term><term>Defibrillators (adverse effects)</term><term>Double-Blind Method</term><term>Echocardiography</term><term>Female</term><term>Follow-Up Studies</term><term>Heart Failure (therapy)</term><term>Heart Ventricles</term><term>Humans</term><term>Male</term><term>Prospective Studies</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Défaillance cardiaque ()</term><term>Défibrillateurs (effets indésirables)</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Méthode en double aveugle</term><term>Sujet âgé</term><term>Thérapie de resynchronisation cardiaque ()</term><term>Thérapie de resynchronisation cardiaque (mortalité)</term><term>Troubles du rythme cardiaque ()</term><term>Ventricules cardiaques</term><term>Échocardiographie</term><term>Études de suivi</term><term>Études prospectives</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Defibrillators</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Défibrillateurs</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Cardiac Resynchronization Therapy</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Cardiac Resynchronization Therapy</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Thérapie de resynchronisation cardiaque</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Arrhythmias, Cardiac</term><term>Heart Failure</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Double-Blind Method</term><term>Echocardiography</term><term>Female</term><term>Follow-Up Studies</term><term>Heart Ventricles</term><term>Humans</term><term>Male</term><term>Prospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Défaillance cardiaque</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Méthode en double aveugle</term><term>Sujet âgé</term><term>Thérapie de resynchronisation cardiaque</term><term>Troubles du rythme cardiaque</term><term>Ventricules cardiaques</term><term>Échocardiographie</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Echocardiography-guided left ventricular (LV) lead placement at the site of latest mechanical activation improves heart failure outcomes in patients receiving a cardiac resynchronization therapy defibrillator (CRT-D). In this study, we test the hypothesis that a strategy of echocardiography-guided LV lead placement improves patient survival rate free from appropriate CRT-D therapy for ventricular arrhythmias. Patients enrolled in the prospective, randomized Speckle Tracking Assisted Resynchronization Therapy for Electrode Region trial and treated with a CRT-D device (108 with the echo-guided strategy and 75 with the routine strategy) were followed to the end point of death or first appropriate CRT-D therapy. Over a follow-up period of 3.7 ± 2.1 years, 62 patients (33%) died and 40 (22%) received appropriate CRT-D therapy. Compared with the routine group, patients in the echo-guided group had improved CRT-D therapy-free survival rate (hazard ratio = 0.64, 95% confidence interval = 0.42 to 0.98, p = 0.038). Patients randomized to the echo-guided LV lead placement were more likely to resynchronize their LV compared with the routine group (72% vs 48%, respectively, p = 0.006). Patients whose LV did resynchronize after CRT-D had improved therapy-free survival rate compared with those whose LV did not resynchronize (hazard ratio = 0.49, 95% confidence interval = 0.28 to 0.86, p = 0.012). In conclusion, a strategy of echo-guided LV lead placement improved the patient survival rate free from defibrillator therapy in CRT-D recipients.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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