Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
Arrhythmia/Electrophysiology
Survival and Heart Failure Hospitalization in Patients With Cardiac Resynchronization Therapy With or Without a Defibrillator for Primary Prevention in Japan ― Analysis of the Japan Cardiac Device Treatment Registry Database ―
Hisashi YokoshikiAkihiko ShimizuTakeshi MitsuhashiHiroshi FurushimaYukio SekiguchiTetsuyuki ManakaNobuhiro NishiiTakeshi UeyamaNorishige MoritaHideo OkamuraTakashi NittaKenzo HiraoKen Okumurafor the Members of the Implantable Cardioverter-Defibrillator (ICD) Committee of the Japanese Heart Rhythm Society
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2017 Volume 81 Issue 12 Pages 1798-1806

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Abstract

Background:Randomized control trials comparing the effectiveness of cardiac resynchronization therapy devices, with (CRT-D) or without (CRT-P) a defibrillator, are scarce in heart failure patients with no prior sustained ventricular tachyarrhythmias.

Methods and Results:The Japan Cardiac Device Treatment Registry (JCDTR) has data for 2714 CRT-D and 555 CRT-P recipients for primary prevention with an implantation date between January 2011 and August 2015. Of these patients, follow-up data were available for 717. Over the mean follow-up period of 21 months, Kaplan-Meier curves of survival free of combined events for all-cause death or heart failure hospitalization (whichever came first) diverged between the CRT-D (n=620) and CRT-P (n=97) groups with a rate of 22% vs. 42%, respectively, at 24 months (P=0.0011). However, this apparent benefit of CRT-D over CRT-P was no longer significant after adjustment for covariates. With regard to mortality, including heart failure death or sudden cardiac death, there was no significant difference between the 2 groups.

Conclusions:In patients without sustained ventricular tachyarrhythmias enrolled in the JCDTR, there was no significant difference in mortality between the CRT-D and CRT-P groups, despite a lower trend in CRT-D recipients. This study was limited by large clinical and demographic differences between the 2 groups.

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© 2017 THE JAPANESE CIRCULATION SOCIETY
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