{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:42:11Z","timestamp":1790419331500,"version":"4.1.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2010,11,16]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Clinical trials of cardiac resynchronization therapy (CRT) have enrolled a select group of patients, with few patients in subgroups such as right bundle-branch block (RBBB). Analysis of population-based outcomes provides a method to identify real-world predictors of CRT outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      Medicare Implantable Cardioverter-Defibrillator Registry (2005 to 2006) data were merged with patient outcomes data. Cox proportional-hazards models assessed death and death\/heart failure hospitalization outcomes in patients with CRT and an implantable cardioverter-defibrillator (CRT-D). The 14 946 registry patients with CRT-D (median follow-up, 40 months) had 1-year, 3-year, and overall mortality rates of 12%, 32%, and 37%, respectively. New York Heart Association class IV heart failure status (1-year hazard ratio [HR], 2.23; 3-year HR, 1.98;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and age \u226580 years (1-year HR, 1.74; 3-year HR, 1.75;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) were associated with increased mortality both early and late after CRT-D. RBBB (1-year HR, 1.44; 3-year HR, 1.37;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and ischemic cardiomyopathy (1-year HR, 1.39; 3-year HR, 1.44;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) were the next strongest adjusted predictors of both early and late mortality. RBBB and ischemic cardiomyopathy together had twice the adjusted hazard for death (HR, 1.99;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) as left BBB and nonischemic cardiomyopathy. QRS duration of at least 150 ms predicted more favorable outcomes in left BBB but had no impact in RBBB. A secondary analysis showed lower hazards for CRT-D compared with standard implantable cardioverter-defibrillators in left BBB compared with RBBB.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>In Medicare patients, RBBB, ischemic cardiomyopathy, New York Heart Association class IV status, and advanced age were powerful adjusted predictors of poor outcome after CRT-D. Real-world mortality rates 3 to 4 years after CRT-D appear higher than previously recognized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.110.956011","type":"journal-article","created":{"date-parts":[[2010,11,2]],"date-time":"2010-11-02T01:21:43Z","timestamp":1288660903000},"page":"2022-2030","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":216,"title":["Bundle-Branch Block Morphology and Other Predictors of Outcome After Cardiac Resynchronization Therapy in Medicare Patients"],"prefix":"10.1161","volume":"122","author":[{"given":"Kenneth C.","family":"Bilchick","sequence":"first","affiliation":[{"name":"From the Departments of Medicine (K.C.B., S.K., J.P.D.) and Public Health Sciences (G.J.S.), University of Virginia Health System, Charlottesville."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Kamath","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (K.C.B., S.K., J.P.D.) and Public Health Sciences (G.J.S.), University of Virginia Health System, Charlottesville."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"DiMarco","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (K.C.B., S.K., J.P.D.) and Public Health Sciences (G.J.S.), University of Virginia Health System, Charlottesville."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George J.","family":"Stukenborg","sequence":"additional","affiliation":[{"name":"From the Departments of Medicine (K.C.B., S.K., J.P.D.) and Public Health Sciences (G.J.S.), University of Virginia Health System, Charlottesville."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050496"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013168"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200103223441202"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.108.768895"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.02.033"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02938362"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.07.011"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2009.02649.x"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2008.08.069"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2009.07.009"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.089656"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_4_16_2","first-page":"145A","article-title":"The resting electrocardiogram provides a sensitive and inexpensive marker of prognosis in patients with chronic congestive heart failure [abstract]","volume":"33","author":"Gottipaty VK","year":"1999","unstructured":"Gottipaty VK, Krelis SP, Fei Lu K. 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