Author:
Iddagoda Hewage Don Sandun Prabath,Kuruppu Kuruppumullage Chamini Nuwansika,Dunuwille Asunga,Wijewardena Asanka,Gunawardena Rohan
Abstract
Abstract
Background
Cardiac resynchronization therapy (CRT) has been a well-established treatment modality for moderate to severe left ventricular systolic dysfunction with left ventricular desynchrony. This is the pioneering study that analyses the cohort who underwent CRT implantation at the National Hospital of Sri Lanka (NHSL) in Colombo from 2005 to 2020.
Objectives
This study was carried out to describe socio-demographic factors, improvements in clinical outcome (symptoms, electrocardiographic, and echocardiographic features), and post-CRT complications in the study population, as well as to determine the efficacy of CRT in heart failure.
Method
A retrospective observational study was conducted on all the living patients who had undergone CRT implantation from 2005 to 2020. The data was gathered from all the consented patients who visited the device programming clinic using a physician-administered questionnaire and clinical records. Data was analyzed using SPSS 25, and significant statistics were assessed with the McNemer test, the Student T test, and the Chi-Squared test.
Results
The study included 50 patients with a mean age of 52.82+/− 11.66 years and female predominance (56%, n = 28). Idiopathic dilated cardiomyopathy (50%, n = 25) was the leading etiological factor, followed by ischemic cardiomyopathy (28%, n = 14). Clinical symptoms have improved significantly with CRT implantation (p < 0.001). A significant improvement was found in NYHA functional class (p < 0.001, 95% CI = 0.072 to 0.284), QRS width (p < 0.001, 95% CI = 0.229 to 0.534), ejection fraction (p < 0.001, 95% CI = − 16.437 to − 8.504), and LV EDD (p < 0.001, 95% CI = 2.89 to 9.24). Post-CRT complications included lead malfunction (6%, n = 3) and chronic (14%, n = 7), bleeding or hematoma (2%, n = 1), pocket erosion or infection (6%, n = 3), and infective endocarditis (2%, n = 1).
Conclusion
According to the study, CRT significantly improves both clinical and functional outcomes in patients with moderate to severe heart failure.
Publisher
Springer Science and Business Media LLC
Reference28 articles.
1. Hypertension and heart failure | circulation (no date). Available at: https://www.ahajournals.org/doi/full/10.1161/circulationaha.111.059303 (Accessed: May 2, 2023).
2. D;, H.K.K.P.J.L.K.W.B.L. (no date) The epidemiology of heart failure: The framingham study, Journal of the American College of Cardiology. U.S. National Library of Medicine. Available at: https://pubmed.ncbi.nlm.nih.gov/8376698/ (Accessed: May 2, 2023).
3. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure (no date) European Society of Cardiology. Available at: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure (Accessed: May 2, 2023).
4. Overview: Chronic heart failure in adults: Diagnosis and management: Guidance (no date) NICE. Available at: https://www.nice.org.uk/guidance/ng106 (Accessed: May 2, 2023).
5. 2022 AHA/ACC/HFSA guideline for the management of heart ... - pubmed (no date). Available at: https://pubmed.ncbi.nlm.nih.gov/35363499/ (Accessed: May 2, 2023).