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Arquivos de Medicina

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Impact of Cardiac Resynchronization Therapy on Heart Failure Patients: Experience from One Center

Ibrahim Abd Elhakam Elzoghby, Ibrahim Attia, Abdo El Azab, Mohammed Hammouda

Background: Cardiac Resynchronization Therapy (CRT) has been proposed as a treatment of patients with idiopathic as well as ischemic left ventricular dysfunction with drug refractory heart failure and intra or inter ventricular conduction delay. CRT improves heart failure, reduces the risk of death and improves the status of LV dysfunction.

Objective: To detect the long term effect of CRT on clinical outcome in patients with heart failure.

Patients and Methods: Over a period of seven years 192 patients were subjected to CRT implantation (according to standard indication) at Critical care department, Faculty of medicine, Cairo University. Patients were assessed before implantation by history taking, clinical examination, ECG and echocardiographic parameters and then the patients were reevaluated after six months at follow visits to detect CRT effect on clinical outcome.

Results: Only 180 patients completed their follow-up visits and we found significant improvement in Ejection Fraction(EF)%, left ventricular dimensions, width of QRS complex and NYHA class (P-value<0.001) six months after CRT implantation. According to improvement in EF ≥ 10% and improvement in NYHA class ≥ 1 class about 58% of our patients were considered responders to CRT and 42% were considered non responders. The percentage of decrease of QRS complex width after CRT implantation correlated significantly with the improvement in EF% (P-value<0.01). The rate of complications was low (13.8%) and all complications were managed successfully.

Conclusion: Cardiac resynchronization therapy had great positive impact on clinical outcome in patients with congestive heart failure and according to our experience in this field CRT implantation is safe with low rate of complications.