In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to HFA Silver & Gold Members, Fellows of the ESC and Young combined Members

Super responders to cardiac resynchronization therapy- A terciary centre experience

Session Poster Session 3

Speaker Sofia Alegria

Congress : Heart Failure 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Cardiac Resynchronization Therapy
  • Session type : Poster Session
  • FP Number : P1540

Authors : A Briosa (Lisbon,PT), A Marques (Lisbon,PT), AR Pereira (Lisbon,PT), S Alegria (Lisbon,PT), D Sebaiti (Lisbon,PT), AC Gomes (Lisbon,PT), R Miranda (Lisbon,PT), S Almeida (Lisbon,PT), L Brandao (Lisbon,PT), H Pereira (Lisbon,PT)

A Briosa1 , A Marques1 , AR Pereira1 , S Alegria1 , D Sebaiti1 , AC Gomes1 , R Miranda1 , S Almeida1 , L Brandao1 , H Pereira1 , 1Hospital Garcia de Orta - Lisbon - Portugal ,


Introduction: Patients submitted to Cardiac Resynchronization Therapy (CRT) implantation may develop response patterns that are higher than expected with almost complete normalization of clinical and echocardiographic parameters (super-responders).

Purpose: To characterize patients (pts) who underwent CRT implantation and to evaluate clinical and echocardiographic characteristics of super-responders.

Methods:  Restrospective study of a single center analysing patients submitted to CRT implantation in the last 6 years (2012-2018). Super-responders were classified as patients who normalized left ventricular ejection fraction (LVEF >= 50%) at 6 months after implantation.

Results: We analysed 103 pts, 65% males with mean age of 70± 10 years, with optimized medical treatment. Non ischemic etiology was present in 74,5% of pts. 68,1% pts had QRS > 150ms and 80,9% had left bundle brunch block (LBBB).  Mean LVEF was 27,9±7,5%, mean left ventricular end-diastolic volume índex (LVEDVI) was 113± 38 ml/m2.  By the time of CRT implantation, 67% of pts were in SR (n=69) and 33% had AF (13,6% with paroxystic AF and 19,4% with persistent AF), and NYHA class 3 was present in 56,3% of pts.  Subsequent hospitalizations occurred in 18,4%, and 11 pts died. 76,7% of pts were considered responders. 21,4% of pts were considered super-responders (n=22).

Comparing both groups (super-responders vs global population), we found no differences between groups in respect to gender (p=0,990), presence of previous sinus rythm (SR) (p=0.156), etiology (p= 0,053) and previous QRS width (p=0,086).

There were also no differences in long term outcomes (hospitalizations (p=0,371) or death (p=1)). However, super-responders had higher baseline ejection fraction (32 vs 26%, p= 0,002), lower left ventricular end-diastolic volume (167 vs 225 ml /m2, p=0,016) and lower left ventricular end-systolic volume (112 vs 156 ml/m2, p=0,016).

Conclusion: In this population, the super-responders appear to be pts with less advanced heart disease at baseline, with higher LVEF and lower left ventricular volumes. Surprisingly, we found no predictors of super-response in this population, not confirming previous studies that associated female sex, non-ischemic etiology and wider QRS duration with a super-response. This raises the question whether there are others non-recognized predictors of CRT response that would improve selection of patients for this therapy. Further studies are necessary to clarify this.

Based on your interests

Three reasons why you should become a member

Become a member now
  • 1Access your congress resources all year-round on the New ESC 365
  • 2Get a discount on your next congress registration
  • 3Continue your professional development with free access to educational tools
Become a member now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are