Erschienen in:
16.02.2023 | COMMENTARY
Downgrade from CRT-D to CRT-P at time of generator replacement: a true clinical conundrum or just an academic debate?
verfasst von:
John-Ross D. Clarke, Daniel J. Friedman
Erschienen in:
Journal of Interventional Cardiac Electrophysiology
|
Ausgabe 6/2023
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Excerpt
Cardiac resynchronization therapy (CRT) is a well-established therapy for patients with symptomatic heart failure, left ventricular (LV) dysfunction, and a prolonged QRS [
1]. CRT induced reverse remodeling can improve quality of life and the risk of heart failure hospitalizations and death. CRT with a defibrillator (CRT-D) has additionally been shown to reduce the risk of ICD therapies compared to ICD alone, and importantly CRT pacemakers reduce the risk of sudden death compared to medical therapy [
2‐
4]. However, the majority of patients who receive a CRT-D have a primary prevention ICD indication. Approximately 80% patients with a CRT-D will not experience a ventricular arrhythmic event (VAE) during the lifetime of their first device and have a lower risk for inappropriate and appropriate ICD therapies compared to their non-CRT ICD counterparts [
5,
6]. …
