[How many patients admitted for heart failure are eligible for cardiac resynchronization therapy? Analysis of the Andalusian Heart Failure Registry (RAIC) study].
OBJECTIVE
The objective was to determine what percentage of patients admitted for heart failure met criteria for cardiac resynchronization therapy.


METHODS
The study involved registry data on heart failure admissions at 16 public hospitals in Andalusia, Spain between May and July 2004. Criteria for cardiac resynchronization therapy from American College of Cardiology and American Heart Association guidelines were applied: a left ventricular ejection fraction < or = 0.35, New York Heart Association functional class III or IV, and a QRS interval > 120 ms. Outcome was evaluated at 3 months. Multivariate (i.e., logistic regression) analysis was used to identify independent variables associated with meeting resynchronization therapy criteria.


RESULTS
The study included 674 patients (43.3% women, mean age 71[11] years). Of these, 5.6% met resynchronization therapy criteria at admission. There was no significant difference in the cardiovascular event rate at 3 months between patients who met resynchronization therapy criteria and those who did not (34.2% vs 23.4%, respectively). Admitting hospital (odds ratio [OR]=0.30, 95% confidence interval [CI], 0.11-0.79), ischemic etiology (OR=2.71, 95% CI, 1.26-5.81), the presence of left bundle branch block (OR=14.97, 95% CI, 5.95-37.64), and mitral regurgitation (OR=4.18, 95% CI, 1.93-9.04) were all independently associated with meeting resynchronization therapy criteria at both admission and short-term follow-up.


CONCLUSIONS
The percentage of patients who met cardiac resynchronization therapy criteria was small, but their short-term prognosis was poor. A number of clinical variables associated with meeting resynchronization therapy criteria were identified.
García-Pinilla
José M
JM
Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain. pinilla@secardiologia.es
Jiménez-Navarro
Manuel F
MF
Anguita-Sánchez
Manuel
M
Martínez-Martínez
Angel
A
Torres-Calvo
Francisco
F
D000368:Aged; D002303:Cardiac Output, Low / Q000401:mortality / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000592:standards / Q000706:statistics & numerical data; D002986:Clinical Trials as Topic; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012737:Sex Factors; D013030:Spain