title: Long-term outcomes of CRT-PM versus CRT-D recipients.
abstract: OBJECTIVE
  To compare the rates of all-cause mortality in recipients of cardiac resynchronization therapy devices without (CRT-PM) versus with defibrillator (CRT-D).
  
  
  METHODS
  Between February 1999 and July 2004, 233 patients (mean age = 69 +/- 8 years, 180 men) underwent implantation of CRT-PM or CRT-D devices. New York Heart Association (NYHA) heart failure functional class II was present in 11%, class III in 69%, and class IV in 20% of patients; mean left ventricle ejection fraction (LVEF) was 26.5 +/- 6.5 %, 48% presented with idiopathic dilated cardiomyopathy and 49% with ischemic heart disease. Cox multiple variable regression analysis was performed in search of predictors of death.
  
  
  RESULTS
  The clinical characteristics of the 117 CRT-PM and 116 CRT-D recipients were similar, except for LVEF (28.2 +/- 6.2% vs 25.0 +/- 6.5%, respectively; P < 0.001), and ischemic versus nonischemic etiology of heart failure (41% vs 56%, respectively P = 0.02). Over a mean follow-up of 58 +/- 15 months, no significance difference in overall mortality rate was observed between the two study groups. Male sex, NYHA functional class IV, and atrial fibrillation at implant were significant predictors of death.
  
  
  CONCLUSIONS
  There was no difference in long-term survival rate among patients with CRT-D versus CRT-PM, although CRT-D more effectively lowered the sudden death rate. Male sex, NYHA functional class IV, and atrial fibrillation predicted the worst prognosis.
authors.affiliation: Clinica Mediterranea, Napoli, Italy. gmrstabile@tin.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Stabile
authors.forename: Francesco
authors.initials: F
authors.lastname: Solimene
authors.forename: Emanuele
authors.initials: E
authors.lastname: Bertaglia
authors.forename: Vincenzo
authors.initials: V
authors.lastname: La Rocca
authors.forename: Michele
authors.initials: M
authors.lastname: Accogli
authors.forename: Alberto
authors.initials: A
authors.lastname: Scaccia
authors.forename: Natale
authors.initials: N
authors.lastname: Marrazzo
authors.forename: Franco
authors.initials: F
authors.lastname: Zoppo
authors.forename: Pietro
authors.initials: P
authors.lastname: Turco
authors.forename: Assunta
authors.initials: A
authors.lastname: Iuliano
authors.forename: Gergana
authors.initials: G
authors.lastname: Shopova
authors.forename: Carmine
authors.initials: C
authors.lastname: Ciardiello
authors.forename: Antonio
authors.initials: A
authors.lastname: De Simone
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome