Clinical and demographic characteristics of patients with congestive heart failure and implanted devices for cardiac resynchronization therapy

Abstract

Clinical recommendations for cardiac resynchronization therapy (CRT) were based on the results of large multicenter studies. However, patients with congestive heart failure (CHF) in real clinical practice differ from the cohort included in randomized trials. Aim of the study was to evaluate the clinical and demographic characteristics of patients with CHF and implanted devices for CRT in real clinical practice according to the local register of implanted cardiac devices and to compare local cohort with patients included in large clinical trials and registers. Material and methods: The study enrolled 218 patients (83 % men, 17 % women) with CHF implanted with CRT devices from January 2003 to December 2018. Results and discussion: When compared to large studies and registers local cohort was significantly younger (75,9 % of patients were younger than 65 age), the mean age was 57,2 ± 10,5 years. NYHA functional class was lower and left ventricular ejection fraction was higher. However, the distribution of comorbidity was higher, 65 % of patients had ≥3 comorbid conditions. Atrial fibrillation (AF) was observed more frequently (38.5 %). Conclusion: Our data demonstrate significant differences between real clinical cohort and cohort of patients included in large multicenter studies. These differences may significantly affect the effectiveness of CRT both positively (lower age, lower NYHA) and negatively (high distribution of AF and other comorbidities). This explains the need for randomized control CRT studies in Russia and the creation of local registers of CRT devices.

Keywords

• cardiac resynchronization therapy
• congestive heart failure