title: Mid-term clinical and echocardiographic evaluation of super responders with and without pacing: the preliminary results of a prospective, randomized, single-centre study.
abstract: OBJECTIVE
  Super response to cardiac resynchronization therapy (CRT) is related to excellent long-term prognosis. However, it is not known whether super responders (SRs) are in remission or have made a complete recovery. In other words, is CRT a destination therapy or a bridge to recovery? The objective was to assess the evolution of the clinical and echocardiographic data of SRs without pacemaker activity at the mid-term follow-up.
  
  
  RESULTS
  A total of 19 SRs were randomly assigned to a deactivated pacemaker function (Off-Pace group) or a continued pacemaker activity (On-Pace group). Clinical and echocardiographic parameters were evaluated before implantation, at randomization, and after 6 and 12 months of this randomization. Patients assigned to the Off-Pace group deteriorated in terms of the New York Heart Association class (from 1.3 ± 0.5 to 2.4 ± 0.7), 6-min walk distance (from 569 ± 68 to 343 ± 162 m), and echocardiographic data, including left ventricular ejection fraction (from 55 ± 3 to 36 ± 12%), left ventricular end-systolic volume (from 61 ± 10 to 117 ± 36 mL), left ventricular end-diastolic diameter (from 53 ± 3 to 61 ± 6 mm), and left ventricular end-systolic diameter (from 40 ± 3 to 53 ± 8 mm) at 12 months, whereas no change was observed in the On-Pace group. Turning off the pacemaker function was also related to hospitalization for heart failure and appropriate cardioverter-defibrillator device intervention.
  
  
  CONCLUSIONS
  Super responders without pacing had poor clinical and echocardiographic outcomes at the mid-term follow-up.
authors.affiliation: Department of Cardiology, Division of Arrhythmia and Electrophysiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey cayserkan@yahoo.com.
authors.forename: Serkan
authors.initials: S
authors.lastname: Cay
authors.affiliation: Department of Cardiology, Division of Arrhythmia and Electrophysiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey.
authors.forename: Ozcan
authors.initials: O
authors.lastname: Ozeke
authors.affiliation: Department of Cardiology, Division of Arrhythmia and Electrophysiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey.
authors.forename: Firat
authors.initials: F
authors.lastname: Ozcan
authors.affiliation: Department of Cardiology, Division of Arrhythmia and Electrophysiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey.
authors.forename: Dursun
authors.initials: D
authors.lastname: Aras
authors.affiliation: Department of Cardiology, Division of Arrhythmia and Electrophysiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Topaloglu
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D013318:Stroke Volume; D016896:Treatment Outcome; D014421:Turkey; D016277:Ventricular Function, Left
keywords: Cardiac resynchronization therapy; Deactivation; Outcome; Super response