Predicting the survival benefit of cardiac resynchronization therapy with defibrillator function for non-ischemic heart failure—Role of the Goldenberg risk score

• DOI: 10.3389/fcvm.2022.1062094
• Publication Date: 2023-01-10T21:11:55Z
• Authors: Eperke D. Merkel; Walter R. Schwertner; Anett Behon; Luca Kuthi; Boglárka Veres; István Osztheimer; Roland Papp; Levente Molnár; Endre Zima; László Gellér; Annamária Kosztin; Béla Merkely
• Keywords: Clinical endpoint; Ischemic Cardiomyopathy

Aims Primary prevention of sudden cardiac death (SCD) in non-ischemic heart failure (HF) patients remains a topic debate at resynchronization therapy (CRT) implantation requiring individual risk assessment. Using the Goldenberg SCD score, we aimed to predict, which HF will benefit from addition an implantable cardioverter defibrillator (ICD) CRT long-term. Methods Between 2000 and 2018 undergoing were collected into our retrospective registry. The score (GRS) was calculated by presence atrial fibrillation, New York Heat Association (NYHA) class > 2, age 70 years, blood urea nitrogen 26 mg/dl QRS 120 ms. primary endpoint all-cause mortality, transplantation or left ventricular assist device implantation. Results From 667 patients, 347 (52%) underwent therapy-pacemaker (CRT-P), 320 (48%) therapy-defibrillator (CRT-D) implantations. During median follow up time 4.3 306 (46%) reached (CRT-D 37% vs. CRT-P 63%; p < 0.001). CRT-D younger (64 69 years; 0.001), infrequently females (26 39%; had lower ejection fraction (27 29%; 0.01) compared patients. After GRS calculation, dichotomized low (< 3) high (≥ scores. with showed mortality (HR 0.68; 95% CI 0.48–0.96; = 0.03), high-risk did not 0.84; 0.62–1.13; 0.26). Conclusion In cohort, clear long-term adding ICD CRT, however, no further could be observed.