1.Is CRT‑D superior to CRT‑P in patients with nonischemic cardiomyopathy?
Mohammed AL‑SADAWI ; Faisal ASLAM ; Michael TAO ; Shafqat SALAM ; Mahmoud ALSAIQALI ; Abhijeet SINGH ; Roger FAN ; Eric J. RASHBA
International Journal of Arrhythmia 2023;24(1):3-
Background:
Recent studies have questioned the role of implanted cardiac defibrillators (ICDs) in nonischemic cardiomyopathy (NICM). Cardiac resynchronization therapy (CRT) can be delivered by a pacemaker (CRT-P) or an ICD (CRT-D). This meta-analysis assessed the effect of CRT-P versus CRT-D on mortality in patients with NICM.
Methods:
Databases were searched for studies reporting the effect of CRT on all-cause mortality in patients with nonischemic cardiomyopathy (Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL). The primary endpoint was all-cause mortality. The minimum duration of follow-up required for inclusion was one year. The search was not restricted to time or publication status.
Results:
The literature search identified 955 candidate studies, 15 studies and 22,763 patients were included. Mean follow-up was 53 months (17–100 months). CRT-D in NICM was associated with lower all-cause mortality (log HR − 0.169, SE 0.055; p = 0.002) compared to CRT-P. Heterogeneity: df = 15 (p 0.03), I2 = 43; test for overall effect: Z = − 3.043 (p = 0.002).
Conclusion
CRT-D in NICM was associated with lower all-cause mortality than CRT-P.