Howard Email Notifier 2.03 download the last version for windows

However, acute HF carries a high risk, possibly high enough to dilute long-term benefits. In this respect, a HFH is a critical event in the trajectory of HF and may provide the opportunity to target patients who are most likely to benefit from CRT. Several small studies 3 and large registries 4, 5 have suggested that CRT should be delivered soon after the detection of HF, even during a HFH. Current guidelines recommend CRT implantation as an elective procedure, in the context of stable HF. 1 The timing of CRT implantation in relation to the time of diagnosis or a heart failure hospitalization (HFH) has not been addressed by randomized, controlled trials. The best outcomes were observed in patients with no previous HFHs and in those undergoing implantation during the first HFH.Ĭardiac resynchronization therapy (CRT) is an established treatment for selected patients with heart failure (HF) and a wide QRS complex.

In this study of a public healthcare system covering an entire nation, increasing time from a first heart failure hospitalization (HFH) to CRT implantation was associated with progressively worse outcomes, with each year amounting to a 21% higher mortality and a 34% higher risk of HFH. The optimum timing of CRT implantation is unknown.

Total mortality (HR: 1.67), HFH (HR: 2.63), and total mortality or HFH (HR: 1.92) (all P < 0.001) were highest in patients undergoing CRT ≥2 years after the first HFH.

Over 4.54 (2.80–6.71) years, the time in years from the first HFH to CRT implantation was associated with a higher risk of total mortality (1.15 95% CI 1.14–1.16, HFH (HR: 1.26 95% CI 1.24–1.28), and the combined endpoint of total mortality or HFH (HR: 1.19 95% CI 1.27–1.20) than CRT in patients with no previous HFHs, after co-variate adjustment. From 2010 to 2019, 64 968 patients underwent CRT implantation, 57% in the absence of a previous HFH, 12.9% during the first HFH, and 30.1% after ≥1 HFH. A database covering the population of England (56.3 million in 2019) was used to quantify clinical outcomes after CRT implantation in relation to first HFHs.

Howard Email Notifier 2.03 download the last version for windows