Functional Response to Cardiac Resynchronization Therapy is Associated with Improved Clinical Outcome and Absence of Appropriate Shocks

Clinical Outcome in Cardiac Resynchronization Therapy (CRT) Functional Responders. Introduction: We evaluated clinical outcome and incidence of (in) appropriate shocks in consecutive chronic heart failure (CHF) patients treated with CRT with a defibrillator (CRT-D) according to functional response status. Furthermore, we investigated which factors predict such functional response. Methods and Results: In a large teaching hospital, 179 consecutive CHF patients received CRT-D in 2005-2010. Patients were considered functional responders if left ventricular ejection fraction (LVEF) increased to >= 35% postimplantation. Analysis was performed on 142 patients, who had CRT-D as primary prevention, complete data and a baseline LVEF <35%. Endpoints consisted of all-cause mortality, heart failure (HF) hospitalizations, appropriate shocks and inappropriate shocks. Median follow-up w Conclusion: Functional responders to CRT have a good prognosis and rarely need ICD therapy. LBBB, QRS duration >= 150 milliseconds and lack of chronic diuretic use predict functional response. (J Cardiovasc Electrophysiol, Vol. 24, pp. 316-322, March 2013)