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dc.contributor.authorFriedman, D. J.
dc.contributor.authorAltman, R. K.
dc.contributor.authorOrencole, M.
dc.contributor.authorPicard, Michael Howard
dc.contributor.authorRuskin, Jeremy Neil
dc.contributor.authorSingh, Jagmeet P.
dc.contributor.authorHeist, Edwin Kevin
dc.date.accessioned2016-10-19T19:27:55Z
dc.date.issued2012
dc.identifier.citationFriedman, D. J., R. K. Altman, M. Orencole, M. H. Picard, J. N. Ruskin, J. P. Singh, and E. K. Heist. 2012. “Predictors of Sustained Ventricular Arrhythmias in Cardiac Resynchronization Therapy.” Circulation: Arrhythmia and Electrophysiology 5 (4) (July 11): 762–772. doi:10.1161/circep.112.971101.en_US
dc.identifier.issn1941-3149en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:29048906
dc.description.abstractBackground: Patients undergoing cardiac resynchronization therapy (CRT) are at high risk for ventricular arrhythmias and risk stratification in this population remains poor. Methods and Results: This study followed 269 patients (LVEF < 35%, QRS > 120ms, NYHA III/IV) undergoing CRT with defibrillator (CRT-D) for 553±464 days after CRT-D implantation to assess for independent predictors of appropriate device therapy for ventricular arrhythmias (VAs). Baseline medication use, medical comorbidities, and echocardiographic parameters were considered. The 4-year incidence of appropriate device therapy was 36%. A Cox proportional hazard model identified left ventricular end systolic diameter (LVESD) > 61mm as an independent predictor in the entire population (HR 2.66, p = 0.001). Those with LVESD > 61mm had a 51% 3-year incidence of VA compared to a 26% incidence among those with a less dilated ventricle (p = 0.001). Among patients with LVESD ≤61mm, multivariate predictors of appropriate therapy were absence of beta-blocker therapy (HR 6.34, p<0.001, LVEF < 20% (HR 4.22, p <0.001), and history of sustained VA (2.97, p = 0.013). Early (<180d after implant) shock therapy was found to be a robust predictor of heart failure hospitalization (HR 3.41, p < 0.004) and mortality (HR 5.16 p < 0.001.) Conclusions: Among CRT-D patients, LVESD > 61mm is powerful predictor of ventricular arrhythmias and further risk stratification of those with less dilated ventricles can be achieved based on assessment of EF, history of sustained VA, and absence of beta-blocker therapy.en_US
dc.language.isoen_USen_US
dc.publisherOvid Technologies (Wolters Kluwer Health)en_US
dc.relation.isversionofdoi:10.1161/CIRCEP.112.971101en_US
dc.relation.hasversionhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766722/en_US
dash.licenseLAA
dc.subjectcardiomyopathyen_US
dc.subjecttachyarrhythmiasen_US
dc.subjectheart failureen_US
dc.subjectpacemakersen_US
dc.subjectrisk factorsen_US
dc.titlePredictors of Sustained Ventricular Arrhythmias in Cardiac Resynchronization Therapyen_US
dc.typeJournal Articleen_US
dc.description.versionAccepted Manuscripten_US
dc.relation.journalCirculation: Arrhythmia and Electrophysiologyen_US
dash.depositing.authorPicard, Michael Howard
dc.date.available2016-10-19T19:27:55Z
dc.identifier.doi10.1161/CIRCEP.112.971101*
dash.contributor.affiliatedSingh, Jagmeet
dash.contributor.affiliatedRuskin, Jeremy
dash.contributor.affiliatedHeist, Edwin
dash.contributor.affiliatedPicard, Michael


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