Article Text

Download PDFPDF

Gender-specific outcomes of cardiac resynchronisation therapy with or without defibrillator
  1. Valentina Kutyifa
  1. Heart Research Follow-Up Program, Cardiology Division, University of Rochester Medical Center, 265 CrittendenBlvd., Rochester, NY 14642, USA
  1. Correspondence to Dr Valentina Kutyifa, Heart Research Follow-up Program, Cardiology Division, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY 14642, USA; valentina.kutyifa{at}

Statistics from

Cardiac resynchronisation therapy has been shown to significantly reduce heart failure (HF) symptoms, prevent HF hospitalisations and improve survival in HF patients with severely reduced left ventricular ejection fraction (LVEF) and a wide QRS.1 Sudden cardiac death (SCD) is also prevalent in HF patients with severely reduced LVEF, and therefore, combined protection from HF and SCD is generally warranted in this cohort. It is however not well known whether adding a defibrillator function to cardiac resynchronisation therapy provides incremental benefit, especially in the context of gender.

In their Heart publication Barra et al.2 reported retrospective analyses of outcomes of 5307 consecutive patients with ischaemic or non-ischaemic cardiomyopathy and no history of sustained ventricular tachyarrhythmia implanted either with cardiac resynchronisation therapy with defibrillator (CRT-D) or without a defibrillator (CRT-P). The primary focus of their report was to assess incremental survival benefit of CRT-D versus CRT-P by gender. Using propensity score matching, they showed no survival advantage of CRT-D versus CRT-P in men or women. Using inverse probability weighting analysis, a benefit of CRT-D over CRT-P was present in men (HR=0.78, 95% CI 0.65 to 0.94, p=0.012) but not in men (HR=0.87, 95% CI …

View Full Text

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles