Responders versus non-responders in Cardiac Resynchronisation Therapy.
Research type
Research Study
Full title
Characteristics of Responders versus Non-Responders in Cardiac Resynchronisation Therapy: a Clinical, Electrocardiographic and Echocardiographic analysis.
IRAS ID
149746
Contact name
Martin Stout
Contact email
Sponsor organisation
Manchester Metropolitan University
Research summary
Cardiac resynchronisation therapy (CRT) is indicated in patients with chronic heart failure (HF) who meet the current guidelines set out by the European Society of Cardiology (left ventricle ejection fraction (LVEF) <35%, a broad QRS morphology, NYHA classification of III- IV and who are on optimal pharmaceutical treatment). Despite its role being supported as an important therapeutic option in HF, the success of CRT is not universal, with approximately 30% of patients not responding to the therapy. On the concept that CRT works to restore synchronisation within the ventricles, an electrocardiographic (ECG) marker of dyssynchrony is already included into the patient selection criteria (broad QRS). Despite this being a good predictive marker for response (Sipahi et al., 2011) there is still the evidence of a 30% non-response rate, suggesting that the selection criterion needs to consider incorporating a wider range of predictive variables. This retrospective study will therefore analyse both ECG and echocardiographic determinants of mechanical dyssynchrony alongside clinical characteristics from patients who have undergone successful CRT (P and D) implantation between 2011 and 2014 within the Heart of England Foundation Trust (HEFT), Birmingham. The aim of which is to provide a greater understanding on which variables predict a patient’s response to CRT and whether there is a combination of variables that contribute rather than variables in isolation. A more in depth understanding will help to optimise the selection criteria for patients. Its importance can be emphasised as an economic benefit in preventing inappropriate use of devices, but more importantly as an ethical perspective, by preventing a patient undergoing an unnecessary or non-beneficial invasive procedure. Overall a better understanding will allow for clearer guidelines in future patient selection.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
14/WM/0151
Date of REC Opinion
4 Jun 2014
REC opinion
Favourable Opinion