Long-Term Outcomes of Upgrading from Chronic RV Pacing to CRT

概要

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Methods: CUBIC study is a registry of Japanese patients undergoing CRT. 650 patients from 11 centers were analyzed after de novo CRT implantation (n=470) and upgrade from chronic RV pacing to CRT (n=180). Results: Compared with the de novo patients, the upgrade patients were more likely to have wide QRS width, chronic atrial fibrillation or flutter and non-ischemic etiology. CRT plus ICD were more frequently indicated in the de novo patients than in the upgrade patients. The crude survival rates were comparable between two groups (at 2 years, de novo: 81.5% vs. upgrade: 82.0%, log rank p=0.13). The rate of freedom from hospitalization for heart failure tended to be higher in the upgrade group (at 2 years, 80.4% vs. 67.2%, p=0.057). There was no significant difference in the rate of reverse LV remodeling defined as LVESV reduction >15% after 6 months (de novo: 56.0% vs. upgrade: 61.4%, p=0.27). Responder rate defined as an improvement (>1 score) of NYHA class after 6 months was similar between two groups (de novo: 66.0% vs. upgrade: 61.3%, p=0.28). Conclusions: Long-term mortality was similar in patients upgraded to CRT after chronic RV pacing to patients undergoing de novo CRT. The degree of LV reverse remodeling was also comparable.