The clinical outcome of cardiac resynchronization therapy in post-surgical XXXX .

@entity1 @entity1000 @entity296
AIMS: Trials have shown that cardiac resynchronization therapy (CRT) is effective in @entity1 with ' @entity296 '. @entity1 with post-surgical @entity296 (PSVCM) have been excluded from such trials. We sought to compare the clinical outcome of CRT in @entity1 with PSVCM, @entity1000 ( @entity1000 ), or @entity296 ( @entity296 ). METHODS AND RESULTS: Clinical events and response to CRT were quantified in 556 @entity1 (PSVCM = 38; @entity1000 = 165; @entity296 = 353) over 4.52 years [median, inter-quartile range (IQR): 4.42]. Response to CRT was defined as survival for >= 1 year free of hospitalizations plus improvement by >= 1 NYHA class or >= 25% in 6-min walking distance. Cardiac resynchronization therapy was initiated at 5.86 years (median, IQR: 9.86) after aortic valve replacement (73.7%) or mitral valve replacement/repair (44.7%). Compared with PSVCM, @entity1000 was associated with a lower total mortality [hazards ratio, HR: 0.54 (95% confidence interval, CI 0.34-0.84)], cardiac mortality [HR: 0.43 (95% CI 0.26-0.70)], and total mortality or major adverse cardiovascular events [HR: 0.57 (95% CI 0.37-0.87)], independent of known confounders. Compared with PSVCM, @entity296 was associated with a similar risk of death from pump failure [HR: 0.83 (95% CI 0.50-1.37)] and @entity1000 was associated with a lower risk [HR: 0.46 (95% CI 0.26-0.82)]. Response to CRT was similar across the groups. CONCLUSIONS: Compared with @entity1000 , PSVCM was associated with a worse outcome after CRT. Outcomes from PSVCM were similar to @entity296 . These findings indicate that PSVCM behaves very differently to @entity1000 after CRT.
