Image: A new study shows resynchronization therapy combined with defibrillation can reduce cardiac events (Photo courtesy of Getty Images).
Cardiac resynchronization therapy (CRT) patients diagnosed with non-ischemic cardiomyopathy would live longer and have fewer hospital admissions if they also received a defibrillator, claims a new study.
Researchers at Aston University (Birmingham, United Kingdom), the University of Birmingham (UB; United Kingdom), and other institutions conducted a study to determine the benefit of CRT with defibrillation (CRT-D) versus CRT with pacing (CRT-P) for patients with non-ischemic cardiomyopathy (NICM), in order to determine which method was superior for reducing complication in patients with left ventricular midwall fibrosis (MWF).
Clinical events were quantified in patients with NICM with MWF (68 patients) or without MWF (184 patients), who underwent cardiac magnetic resonance imaging (MRI) prior to CRT device implantation. The results revealed that total mortality, total mortality or heart failure hospitalization, and total mortality or hospitalization for major adverse cardiac events were all lower after CRT-D than after CRT-P in patients with MWF, but not in those without MWF. The study was published on August 28, 2017, in Journal of the American College of Cardiology (JACC).
“The addition of a defibrillator would be very advantageous to patients who also have heart muscle scar tissue, in that they will potentially live longer and will be less likely to be admitted to hospital for heart failure or other cardiac problems,” concluded senior author professor of cardiology Francisco Leyva, MD, of Aston University. “We are recommending that defibrillators should be added to patients with cardiomyopathy with heart muscle scars who are being treated with cardiac resynchronization therapy.”
A CRT implanted device coordinates the contractions between the heart’s left and right ventricles, while an implanted defibrillator helps to control life-threatening arrhythmias. In cardiomyopathy, the heart muscle becomes enlarged or thickens, and in some cases muscle tissue is replaced with scar tissue. The heart thus grows weaker and less able to pump blood and maintain normal electrical rhythm. This can lead to heart failure, irregular pulse, and complications that include ascites and valvular problems.
University of Birmingham