{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:36:09Z","timestamp":1762508169335,"version":"3.41.2"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Mild heart failure (HF) patients without left bundle branch block (LBBB) did not derive a significant reduction in risk of a HF event\/death in the MADIT-CRT trial (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy). However, the efficacy of CRT with a defibrillator (CRT-D) may be modified after the development of the first hospitalization for HF (HHF). We aimed to study the effect of CRT-D on long-term risk of recurrent HHF in patients without LBBB in MADIT-CRT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Data on recurring HHF were collected for 1818 subjects. The CRT-D versus implantable cardioverter-defibrillator-only risk for first and subsequent HHF was assessed by QRS morphology in on-treatment analysis using Cox proportional hazards regression modeling.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              During long-term follow-up, 412 patients had \u22651 HHF and 333 had \u22652 HHF. Multivariate analysis revealed that in LBBB patients, CRT-D, compared with implantable cardioverter-defibrillator, was associated with a significant reduction in risk of first and subsequent HHF (first: hazard ratio, 0.41 [95% CI, 0.31\u20130.54],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; subsequent: hazard ratio, 0.45 [95% CI, 0.29\u20130.70],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Among patients without LBBB, the benefit of CRT-D was nonsignificant for the first HHF (hazard ratio, 0.96;\n              <jats:italic>P<\/jats:italic>\n              =0.808). However, after occurrence of a first HHF, CRT-D therapy was associated with a pronounced 44% reduction in risk of subsequent HHF (hazard ratio, 0.56 [95% CI, 0.32\u20130.97],\n              <jats:italic>P<\/jats:italic>\n              =0.039). Patients without LBBB with \u22651 HHF during the first year of follow-up demonstrated increasing dyssynchrony at 1 year compared with those who had no HHF (\n              <jats:italic>P<\/jats:italic>\n              =0.016).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In MADIT-CRT, we show a beneficial effect of CRT-D in patients without LBBB subsequent to development of a first HHF, possibly due to increased dyssynchrony associated with HF progression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00180271, NCT01294449, and NCT02060110.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.120.006925","type":"journal-article","created":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T09:00:22Z","timestamp":1593594022000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Cardiac Resynchronization Therapy and Risk of Recurrent Hospitalizations in Patients Without Left Bundle Branch Block"],"prefix":"10.1161","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct01294449","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct00180271","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02060110","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6169-4806","authenticated-orcid":true,"given":"Himabindu","family":"Vidula","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (H.V., E.L., S.M., B.P., M.A., S.R., A.Y., W.Z., V.K., I.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (H.V., E.L., S.M., B.P., M.A., S.R., A.Y., W.Z., V.K., I.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"McNitt","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (H.V., E.L., S.M., B.P., M.A., S.R., A.Y., W.Z., V.K., I.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bronislava","family":"Polonsky","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (H.V., E.L., S.M., B.P., M.A., S.R., A.Y., W.Z., V.K., I.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Aktas","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (H.V., E.L., S.M., B.P., M.A., S.R., A.Y., W.Z., V.K., I.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spencer","family":"Rosero","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (H.V., E.L., S.M., B.P., M.A., S.R., A.Y., W.Z., V.K., I.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arwa","family":"Younis","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (H.V., E.L., S.M., B.P., M.A., S.R., A.Y., W.Z., V.K., I.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (S.D.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Zareba","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (H.V., E.L., S.M., B.P., M.A., S.R., A.Y., W.Z., V.K., I.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Kutyifa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (H.V., E.L., S.M., B.P., M.A., S.R., A.Y., W.Z., V.K., I.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilan","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (H.V., E.L., S.M., B.P., M.A., S.R., A.Y., W.Z., V.K., 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Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCHEARTFAILURE.120.006925","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T01:39:53Z","timestamp":1715564393000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCHEARTFAILURE.120.006925"}},"subtitle":["The Long-Term Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy"],"short-title":[],"issued":{"date-parts":[[2020,7]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1161\/CIRCHEARTFAILURE.120.006925"],"URL":"https:\/\/doi.org\/10.1161\/circheartfailure.120.006925","relation":{},"ISSN":["1941-3289","1941-3297"],"issn-type":[{"type":"print","value":"1941-3289"},{"type":"electronic","value":"1941-3297"}],"subject":[],"published":{"date-parts":[[2020,7]]},"assertion":[{"value":"2020-01-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e006925"}}