Medtronic
 
 

Heart Failure

InSync 7272 ICD Study

Kuhlkamp V, for the InSync 7272 ICD World Wide Investigators. Initial experience with an implantable cardioverter-defibrillator incorporating cardiac resynchronization therapy. J Am Coll Cardiol. 2002;39:790-797.

This prospective, multicenter study evaluated the safety and efficacy of an ICD with CRT in 84 patients with a standard ICD indication, symptomatic heart failure (HF) despite appropriate HF therapy, left ventricular (LV) ejection fraction <35%, LV end-diastolic diameter >55 mm, and a QRS duration >130 ms.

In 81 of 84 (96.4%) patients, the LV lead was successfully implanted. Patients showed significant improvement in:

  • Six-minute hall walk (baseline 304±131 m; 3 months 397±142 m; p<0.001)
  • Quality of life (baseline 38.9±21.2; 3 months 26.5±21.2; p<0.001)
  • New York Heart Association class (baseline 2.8±0.6; 3 months 2.2±0.5)

Additionally:

  • LV end-diastolic diameter decreased (from 79.6±13.0 mm to 73.6±12.9 mm; p=0.002)
  • LV end-systolic diameter decreased (from 68.3±13.5 mm to 63.9±12.9 mm; p<0.001)
  • Fractional shortening increased (from 16±6% to 18±6%; p=0.018)

Twenty-six patients experienced 472 episodes of spontaneous sustained VT, all of which were successfully terminated except 16 episodes that occurred in a patient with incessant VT. Biventricular antitachycardia pacing was found to be more effective than right ventricular antitachycardia pacing (p<0.001). During follow-up (median 185 days, range 12 to 344 days) five patients died of progressive HF.

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