Cardiac resynchronization therapy in acute heart failure and left bundle-branch block in a real-life registry

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• dc.contributor.author Aguiló, Oriol
• dc.contributor.author Trullàs, Joan Carles
• dc.contributor.author Espinosa, Begoña
• dc.contributor.author López Ayala, Pedro
• dc.contributor.author Gil, Víctor
• dc.contributor.author López-Grima, María Luisa
• dc.contributor.author Herrero-Puente, Pablo
• dc.contributor.author Jacob, Javier
• dc.contributor.author López Díez, María Pilar
• dc.contributor.author Garrido, José Manuel
• dc.contributor.author Millán, Javier
• dc.contributor.author Aguirre Tejedo, Alfons
• dc.contributor.author Piñera, Pascual
• dc.contributor.author Müller, Christian E.
• dc.contributor.author Llorens, Pere
• dc.contributor.author Miró, Òscar
• dc.date.accessioned 2025-02-14T07:07:16Z
• dc.date.available 2025-02-14T07:07:16Z
• dc.date.issued 2023
• dc.description.abstract Objectives: To determine the prevalence, characteristics, timing of implementation and prognosis of patients with left bundle branch block (LBBB) and acute heart failure (AHF) treated with cardiac resynchronization therapy (CRT) in a real-life registry. Methods: We analysed the characteristics of patients with AHF and LBBB at the time of inclusion in the EAHFE (Epidemiology Acute Heart Failure Emergency) cohort to determine the indication for CRT, the timing of implementation and its impact on 10-year all-cause mortality. Results: 729 patients with a median age of 82 years and there was a high burden of comorbidities and functional dependence. The median left-ventricle ejection fraction (LVEF) was 40%. Forty-six (6%) patients were treated with CRT at some point during follow-up, with a median time of delay for CRT implementation of 960 (IQR=1,147 days) and at least 108 more untreated patients fulfilled criteria for CRT. Patients receiving CRT were younger, had different comorbidities, less functional dependence (higher Barthel index) and lower LVEF values. The median follow-up was 5.7 years (95% CI: 5.6-5.8) and CRT was not associated with changes in 10-year mortality (adjusted HR 1.33, 95% CI: 0.72-2.48; p-value 0.4). When compared with untreated patients fulfilling criteria for CRT, very similar results were observed (adjusted HR 1.34, 95% CI: 0.67-2.68). Conclusions: CRT implementation was delayed and underused in patients with AHF and LBBB. Under these circumstances, CRT is not associated with a reduction in all-cause mortality in the long term.
• dc.format.mimetype application/pdf
• dc.identifier.citation Aguiló O, Trullàs JC, Espinosa B, López-Ayala P, Gil V, López-Grima ML, et al. Cardiac resynchronization therapy in acute heart failure and left bundle-branch block in a real-life registry. Colomb Med (Cali). 2023 Dec 29;54(4):e2015850. DOI: 10.25100/cm.v54i4.5850
• dc.identifier.doi http://dx.doi.org/10.25100/cm.v54i4.5850
• dc.identifier.issn 0120-8322
• dc.identifier.uri http://hdl.handle.net/10230/69609
• dc.language.iso eng
• dc.publisher Universidad del Valle
• dc.relation.ispartof Colomb Med (Cali). 2023 Dec 29;54(4):e2015850
• dc.rights This work is under License Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) .
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Bundle-branch block
• dc.subject.keyword Cardiac resynchronization therapy
• dc.subject.keyword Heart failure
• dc.subject.keyword Mortality
• dc.title Cardiac resynchronization therapy in acute heart failure and left bundle-branch block in a real-life registry
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion