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Cardiology Research and PracticeVolume 2012 2012, Article ID 319205, 4 pages

Research Article

Hartford Hospital, University of Connecticut, Hartford, CT 06102, USA

Department of Cardiology, Hartford Hospital, Hartford, CT 06102, USA

Department of Pharmacy, Hartford Hospital, Hartford, CT 06102, USA

Department of Electrophysiology, Hartford Hospital, Hartford, CT 06102, USA

CHF Department, Hartford Hospital, Hartford, CT 06102, USA

Received 9 January 2012; Revised 4 June 2012; Accepted 22 June 2012

Academic Editor: John A. Elefteriades

Copyright © 2012 Faisal Zaeem et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. ACC-HRS Guidelines for Cardiac Resynchronization Therapy ICD implantation CRT-D do not include patients with advanced nonambulatory NYHA class-four CHF due to an expectation of limited survival. There is little data available from these large multicenter randomized studies to support or refute this claim. Purpose. We evaluated the outcomes of patients with advanced nonambulatory NYHA class-four CHF who received CRT-D devices as an attempt to improve the clinical status and promote hospital discharge. Methods. Sixteen of our six hundred and seventy CRT-D patients were classified as advanced nonambulatory NYHA Class four inotrope-vasodilator-diuretic-dependent patients. These patients were analyzed retrospectively for weaning success to oral medications, hospital discharge, hemodynamic stability, and survival over eighteen months. Results. Thirteen of sixteen patients were discharged to home within two weeks of implantation. The survival to hospital discharge, as well as at six, twelve, and eighteen months was positive ninety-four percent, seventy-five percent, sixty-nine percent, sixty-nine percent, resp

The groups showed significant improvements in systolic blood pressure, renal function, left ventricular ejection fraction, and CHF class. Conclusion. CRT-D in advanced nonambulatory NYHA four patients proved feasible and beneficial. These findings suggest that the strategy merits further study.





Autor: Faisal Zaeem, Dalia Giedriemiene, Craig Coleman, Eric Crespo, Joseph Radojevic, Steven Zweibel, Jeffrey Kluger, and Christo

Fuente: https://www.hindawi.com/



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