Objective To evaluate whether cardiac resynchronisation therapy （CRT） implantation was feasible and safe in octogenarians and the asso- ciation with symptoms. Methods Consecutive patients undergoing CRT implantation...Objective To evaluate whether cardiac resynchronisation therapy （CRT） implantation was feasible and safe in octogenarians and the asso- ciation with symptoms. Methods Consecutive patients undergoing CRT implantation were recruited from two UK centers. Patients grouped according to age： 〈 80 ＆ ≥ 80 years. Baseline demographics, complications and outcomes were compared between those groups. Results A total of 439 patients were included in this study, of whom 26% were aged ≥ 80 years. Octogenarians more often received cardiac resynchronization therapy pacemaker in comparison to cardiac resynchronisation therapy-defibrillator. Upgrade from pacemaker was common in both groups （16% 〈 80 years vs. 22% ≥ 80 years, P = NS）. Co-morbidities were similarly common in both groups （overall diabetes： 25%, atrial fibrillation： 23%, hypertension： 45%）. More patient age ≥ 80 years had significant chronic kidney disease （CKD, estimated glomerular filtration rate 〈 45 mL/min per 1.73 m^2, 44% vs. 22%, P 〈 0.01 ）. Overall complication rates （any） were similar in both groups （16% vs. 17%, P = NS）. Both groups demonstrated symptomatic benefit. One-year mortality rates were almost four fold greater in octogenarians as compared with the younger cohort （13.9% vs. 3.7%, P 〈 0.01）. Conclusions CRT appears to be safe in the very elderly despite extensive co-morbidity, and in particular frequent severe CKD. Symptomatic improvement appears to be meaningful. Strategies to increase the appropriate identification of elderly patients with CHF who are potential candidates for CRT are required.展开更多
Percutaneous approaches to reduce mitral regurgitation in ischemic cardiomyopathy have stirred interest recently.Patients with ischemic cardiomyopathy and functional mitral regurgitation often meet criteria for cardia...Percutaneous approaches to reduce mitral regurgitation in ischemic cardiomyopathy have stirred interest recently.Patients with ischemic cardiomyopathy and functional mitral regurgitation often meet criteria for cardiac resynchronisation therapy to improve left ventricular function as well as mitral regurgitation,and alleviate symptoms.This case shows that implantation of a pacing lead in the coronary sinus to restore synchronous left and right ventricular contraction is feasible,despite the presence of a remodeling device in the coronary sinus.展开更多
I have read the article entitled ＂Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly？＂ by Olechowski, et al. with great interest, recently published in Journal of Geriatric Cardi...I have read the article entitled ＂Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly？＂ by Olechowski, et al. with great interest, recently published in Journal of Geriatric Cardiology. The investigators reported that implantation of cardiac resynchronisation therapy （CRT） is feasible and safe in very elderly despite extensive co-morbidity.展开更多
文摘Objective To evaluate whether cardiac resynchronisation therapy （CRT） implantation was feasible and safe in octogenarians and the asso- ciation with symptoms. Methods Consecutive patients undergoing CRT implantation were recruited from two UK centers. Patients grouped according to age： 〈 80 ＆ ≥ 80 years. Baseline demographics, complications and outcomes were compared between those groups. Results A total of 439 patients were included in this study, of whom 26% were aged ≥ 80 years. Octogenarians more often received cardiac resynchronization therapy pacemaker in comparison to cardiac resynchronisation therapy-defibrillator. Upgrade from pacemaker was common in both groups （16% 〈 80 years vs. 22% ≥ 80 years, P = NS）. Co-morbidities were similarly common in both groups （overall diabetes： 25%, atrial fibrillation： 23%, hypertension： 45%）. More patient age ≥ 80 years had significant chronic kidney disease （CKD, estimated glomerular filtration rate 〈 45 mL/min per 1.73 m^2, 44% vs. 22%, P 〈 0.01 ）. Overall complication rates （any） were similar in both groups （16% vs. 17%, P = NS）. Both groups demonstrated symptomatic benefit. One-year mortality rates were almost four fold greater in octogenarians as compared with the younger cohort （13.9% vs. 3.7%, P 〈 0.01）. Conclusions CRT appears to be safe in the very elderly despite extensive co-morbidity, and in particular frequent severe CKD. Symptomatic improvement appears to be meaningful. Strategies to increase the appropriate identification of elderly patients with CHF who are potential candidates for CRT are required.
文摘Percutaneous approaches to reduce mitral regurgitation in ischemic cardiomyopathy have stirred interest recently.Patients with ischemic cardiomyopathy and functional mitral regurgitation often meet criteria for cardiac resynchronisation therapy to improve left ventricular function as well as mitral regurgitation,and alleviate symptoms.This case shows that implantation of a pacing lead in the coronary sinus to restore synchronous left and right ventricular contraction is feasible,despite the presence of a remodeling device in the coronary sinus.
文摘I have read the article entitled ＂Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly？＂ by Olechowski, et al. with great interest, recently published in Journal of Geriatric Cardiology. The investigators reported that implantation of cardiac resynchronisation therapy （CRT） is feasible and safe in very elderly despite extensive co-morbidity.
