Oct 27, 2015 - Indication for device therapy in heart failure patients after a comprehensive cardiac .... Electrical cardiac contractility modulation in CRT patients.
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Resynchronisation therapy
safe and could be cost-effective. Considering the economic situation, larger studies about safety and cost-effectiveness of CRT-D downgrade are guaranteed.
D. Koermendy, R. Krause, J.P. Schmidt, H. Saner, M. Wilhelm. University Hospital of Bern, University Clinic for Cardiology, Bern, Switzerland
P3208 | BEDSIDE Electrical cardiac contractility modulation in CRT patients
Background: Exercise based comprehensive Cardiac Rehabilitation (CR) has been shown to improve New York Heart Association (NYHA) functional class and Left Ventricular Ejection Fraction (LVEF) in Heart Failure (HF) patients. Implantable Cardioverter Defibrillators (ICD) and Cardiac Resynchronization Therapy Defibrillators (CRT-D) reduce mortality in selected patients with persistent symptoms and reduced LVEF. We sought to determine the proportion of patients with a remaining indication for device therapy after a 3 month CR program. Methods: We performed a retrospective, longitudinal study in HF patients with a LVEF ≤35% in NYHA functional class I to III, who successfully completed a 3 months CR program. The exercise training consisted of 36 sessions, including endurance and strength training. Medication was optimized during the program. LVEF, peak oxygen uptake (VO2), and Brain Natriuretic Peptide (BNP) were determined at baseline and after the program. Indications for device therapy were based on the European Society of Cardiology guidelines for management of HF (2012) and sudden cardiac death (2006). Results: A total of 300 patients were included in the analysis (mean age 59±11 years, 13.3% female). 50.7% had ischemic, 38.7% had idiopathic dilated cardiomyopathy, and 10.6% had other cardiomyopathies. At baseline, median (IQR) VO2 peak was 16.6 (5.1) ml/min/kg, LV ejection fraction was 25 (10)%, and BNP was 269 (377) pg/ml. After three months, all parameters improved significantly: peak VO2 to 17.9 (7.3) ml/min/kg, p
