The Heart Rhythm Society held its 2010 annual scientific sessions from May 12 to 15 in Denver. The features below highlight some of the news emerging from the meeting.
CRT Devices Improve Mortality in Women
The Particulars: Historically, women have been significantly under-represented in large cardiac resynchronization therapy (CRT) device trials. Researchers conducted a sub-study of the Multicenter Automatic Defibrillator Implantation Trial-CRT (MADIT-CRT); 25% of the participants in MADIT-CRT were women.
Data Breakdown: Patients were randomly assigned to receive CRT device therapy or implantable cardioverter defibrillators. CRT device therapy was associated with a 34% overall reduction of death and heart failure (HF) in minimally symptomatic patients. Women received a significant benefit from CRT device therapy by reducing all-cause mortality by 72%. HF and death end points in the female population were reduced by 69%, compared with a 28% rate for the male population.
Take Home Pearls: Women appear to receive a clinically significant benefit from CRT devices. This therapy appears to reduce all-cause mortality as well as HF and death in women.
Post-Op AF Rates Lower in African Americans
The Particulars: More than 2 million Americans are living with atrial fibrillation (AF). Risk factors known to be associated with AF include gender, age, hypertension, diabetes, and cardiovascular disease. Race had previously not been considered a risk factor, but recent data have shown a correlation.
Data Breakdown: A study examined 1,001 adults without prior AF who underwent CABG surgery. African American patients had a higher prevalence of risk factors associated with AF, compared with Caucasian patients, but only 18% of African Americans developed postoperative CABG AF, compared with a 29% rate observed in Caucasians. Caucasians were 60% more likely than African Americans to develop AF following CABG surgery.
Take Home Pearl: African Americans appear to have a significantly lower incidence of postoperative AF when compared with Caucasians despite having a higher prevalence of risk factors for AF.
Strategic Programming May Reduce ICD, CRT Shocks
The Particulars: Previous trials have shown that programming implantable cardiac defibrillators (ICDs) and cardiac resynchronization therapy (CRT) devices can reduce shocks. A study was performed to analyze the impact of programming strategies on patients.
Data Breakdown: Study results showed that strategic programming of faster ventricular tachycardia/ventricular fibrillation detection thresholds, longer detection durations, supraventricular tachycardia discriminators, and antitachycardia pacing for fast ventricular tachycardias reduced shocks. Strategic programming of ICDs and CRT devices resulted in overall shock reductions between 17% and 28%, depending on the programming of specific variables. Reducing the total number of shock episodes resulted in more effective care and improved quality of life.
Take Home Pearls: Strategic programming appears to result in significant reductions of ICD and CRT device shocks. The choices clinicians make at the time of programming may make a difference in patient outcomes and overall survival.
