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Revista Uruguaya de Cardiología

On-line version ISSN 1688-0420


BONINO, Agustina et al. Terapia de resincronización cardíaca: experiencia a diez años y análisis de la evolución clínica de los pacientes en un centro de nuestro país. Rev.Urug.Cardiol. [online]. 2014, vol.29, n.2, pp.173-180. ISSN 1688-0420.

Introduction: Cardiac resynchronization therapy (CRT) by biventricular pacing (BiV) is an established treatment that has been shown to reduce mortality and improve functional capacity and quality of life in a subgroup of patients with advanced heart failure. In Uruguay, reports about the number of implants, the clinical course of patients and follow-up data are scarce. Methods: A prospective cohort of 85 consecutive patients with CRT implantation was enrolled between June/2000 and May/2011. The follow up period was closed on 31/07/2011. Clinical characteristics: average age 62 y.o., 65% were men, 35% had coronary artery disease. Twenty-two patients received a CRT with defibrillator (CRT-D) device and 63 patients a CRT pacemaker only (CRT-P) device; 71 patients received de novo CRT implantations and in 9 patients were upgrades. Clinical outcome according to the change in NYHA functional class (FC) was assessed. Survival curves were calculated by the Kaplan-Meier method (KM), using the SPSS V20.0. Results: At the time of implant, 2 (3%) patients who were in FC II progressed to FCI. 68% (54) of the patients were in FC III before implantation: 30 patients (55.5%) improve to FC I and 7 patients (13 %) a FCII. Of the 24 patients (30%) who were in class IV, 7 patients (29%) improve to FCII and 8 patients (33%) to FCI. Survival of patients: After a median follow up of 21 months, the cumulative probability of survival at 2 years was 75.5% and at 5 years of 67%. The median survival was 83.5 months [CI95% 68.1 to 98.8]). Conclusion: The CRT in our centre was associated with improvement in FC and lower mortality than expected in the population studied. Medical treatment of that population for CRT is suboptimal. The implant success rates and incidence of venous complications are similar to international reports.


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