New data may help doctors better target mild heart failure patients who are more likely to be "super-responders" to cardiac rhythm therapy.
This class of patients exhibits significant improvements in cardiac function with greater survival rates and lower heart-failure related hospitalizations, according to researchers, sometimes becoming symptom-free within as little as 6 months of device implantation.
The so-called super-responders, generally mildly symptomatic heart failure patients to begin with, could be targeted using 6 independent predictors, according to an analysis stemming from the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization trial:
- Women are more commonly super-responders than men
- No prior myocardial infarctions in the medical history
- Body mass index below 30kg/m2
- QRS score above 130 ms (an indirect measure of ventricular synchronicity)
- Left-bundle-branch block (an electrocardiogram reading suggesting a delay in the left ventricle compared with contraction of the right ventricle)
- Smaller left-atrial volume index
The body-mass index and LAVI predictors were new in this study, while the others had previously arisen in previous analyses of MADIT-CRT data, Heartwire reported.
The predictors could help doctors target mild heart failure patients who would most benefit from receiving CRT, especially for those who are apprehensive about undergoing the procedure, according the the news site.
"CRT implantation for somebody who otherwise feels pretty well may not be something they are keen to do, or they may need more convincing to do it," lead author Dr. Jonathan Hsu told Heartwire. "If one of these mildly symptomatic patients is in your office talking with you about this therapy, it would be useful to know whether they have one or a few of these independent predictors of a super-response."