Implant of Cardiac Resynchronization Therapy Device in Patients with High Percentage of Right Ventricular Pacing and Refractory Heart Failure

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Abstract

Introduction: Implant of a cardiac resynchronization therapy device in patients with pacemaker or implantable cardioverter defibrillator who develop heart failure with left ventricular dysfunction is controversial.

Objective: To evaluate the outcome of these patients after upgrading.
Methods: Patients undergoing upgrading between 2011 and 2015 were evaluated.

Results: A total of 21 patients were included; mean age was 70.7 ± 10-8 years. Mean QRS duration was 180.9 ± 23.2 ms and left ventricular ejection fraction was 26.8 ± 7.7%. The frequency of right ventricular pacing was 90.5 ± 19.3%. Ten patients were in functional class II and 11 in FC III. The implant was successful in 18 patients (85.7%). Left ventricular ejection fraction was 33.9 ± 10.4% one year after upgrading (p = 0.028). Thirteen patients improved their
functional class in at least one category and only 4 were rehospitalized due to heart failure (p = 0.048). The rate of complications was 14.28%.

Conclusions: Upgrading therapy improved symptoms and reduced hospitalizations due to heart failure.