Image For Activity Cover
The Lead Episode 65: QRS Morphology and the Risk of Ventricular Tachyarrhythmia in Cardiac Resynchronization Therapy Recipients
Description
Deepthy Varghese, MSN, ACNP, FNP, Northside Hospital  is joined by James O'Hara, PhD, PA, Virginia Heart and Shunmuga Sundaram Ponnusamy, MBBS, MD, CEPS-A, Velammal Medical College Hospital and Research Institute to discuss a study that evaluated the impact of QRS morphology on the risk of life-threatening ventricular arrhythmias in heart failure patients treated with cardiac resynchronization therapy with a defibrillator (CRT-D). The analysis included 2,862 patients from five major ICD trials, focusing on those with a QRS duration of ≥130 ms. Patients were categorized into those receiving ICD-only or CRT-D. Key findings: Among patients with left bundle branch block (LBBB), those with CRT-D showed a significant 44% reduction in the risk of fast ventricular tachycardia (VT)/ventricular fibrillation (VF) compared to ICD-only patients. They also had a lower burden of fast VT/VF and fewer appropriate shocks. In patients with non-left bundle branch block (NLBBB), CRT-D did not reduce the risk of fast VT/VF and was associated with a significant increase in the burden of fast VT/VF events compared to ICD-only patients. The study concludes that CRT-D effectively reduces life-threatening ventricular arrhythmias in LBBB patients but may increase the risk in NLBBB patients. 
Learning Objectives
  • Learn how cardiac resynchronization therapy with a defibrillator (CRT-D) significantly reduces the risk of fast ventricular tachycardia (VT) and ventricular fibrillation (VF) in heart failure patients with left bundle branch block (LBBB) but may increase the risk of these arrhythmias in patients with non-left bundle branch block (NLBBB).
  • Explore the importance of QRS morphology in predicting outcomes of CRT-D therapy, including the reduction in the burden of fast VT/VF and appropriate shocks in LBBB patients, contrasted with the increased burden of arrhythmic events in NLBBB patients. 
Article Authors and Podcast Contributors
Article Authors
Ido Goldenberg, Mehmet K. Aktas, Wojciech Zareba, David Tsu-Chau Huang, Spencer Z. Rosero, Arwa Younis, Scott McNitt, Martin Stockburger, Jonathan S. Steinberg, Rupinder S. Buttar, Bela Merkely, Valentina Kutyifa 

Podcast Contributors

Deepthy Varghese, MSN, ACNP, FNP, Northside Hospital
James O'Hara, PhD, PA, Virginia Heart
Shunmuga Sundaram Ponnusamy, MBBS, MD, CEPS-A, Velammal Medical College Hospital and Research Institute

Disclosure Policy

ACE Disclosure Policy

The Heart Rhythm Society is committed to the provision of Accredited Continuing Education (formerly known as Continuing Medical Education (CME)) that is balanced, objective, and evidence based. HRS adheres to the Standards for Integrity and Independence in Accredited Continuing Education of the Accreditation Council for Continuing Medical Education (ACCME) which require that those individuals in a position to control the content of an educational activity (including, but not limited to, planners, faculty, authors, committee members, content reviewers, editors, and staff) disclose all financial relationships with an ACCME-defined ineligible company* within the 24 months prior to the disclosure.

 

Any individual who refuses to disclose financial relationships is disqualified from participating in HRS ACE-certified activities. Owners and employees of ACCME-defined ineligible companies may have no role in the planning or implementation of ACE activities without a special written exemption from the HRS Chief Learning Officer that will be granted only in specific circumstances that meet ACCME requirements.


ACCME Definition:

*An ineligible company is one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Examples of such organizations include:

  • Advertising, marketing, or communication firms whose clients are ineligible companies
  • Bio-medical startups that have begun a governmental regulatory approval process
  • Compounding pharmacies that manufacture proprietary compounds
  • Device manufacturers or distributors
  • Diagnostic labs that sell proprietary products
  • Growers, distributors, manufacturers or sellers of medical foods and dietary supplements
  • Manufacturers of health-related wearable products
  • Pharmaceutical companies or distributors
  • Pharmacy benefit managers
  • Reagent manufacturers or sellers

 

All relevant financial relationships have been mitigated.

Host Disclosure(s):

D. Varghese: Nothing to disclose. 

Contributor Disclosure(s):

J. O'Hara: Honoraria, Speaking, and Consulting: Medtronic Inc., Boston Scientific 
S. Ponnusamy: Honoraria, Speaking, and Consulting: Medtronic Inc.

Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):
S. Sailor: No relevant financial relationships with ineligible companies to disclose.
S. Colbert: No relevant financial relationships with ineligible companies to disclose.
ACE Statements
Accreditation Statement

The Heart Rhythm Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Physicians AMA Designation Statement
The Heart Rhythm Society designates this internet-enduring activity for a maximum of .25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABIM Maintenance of Certification (MOC) Statement 
A picture containing text, signDescription automatically generated

Successful completion of this ACE activity, which includes participation in the evaluation component, enables the participant to earn up to .25 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of ACE credits claimed for the activity. It is the ACE activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Royal College of Physicians and Surgeons of Canada MOC Recognition Statement
Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “ACE in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Other Credit Available
A Credit Certificate (for physicians) or Certificate of Participation (for non-physicians) will be provided to individuals seeking credit from the following organizations which accept AMA PRA Category 1 Credit(s)™. Note that participants are advised to contact their certifying body for specific information regarding credit submissions:
·         American Academy of Family Physicians (AAFP) (for elective credit)
·         American Academy of Nurse Practitioners Certification Board (AANPCB)
·         American Academy of Physician Assistants (AAPA)
·         American Nurses Credentialing Center (ANCC)
·         American Osteopathic Association (AOA) (for Category 2 credit)
·         Committee on Accreditation of Continuing Medical Education (Canada)
·         European Board for Accreditation in Cardiology (EBAC)
·         European CME Credits (ECMEC)
·         German Chambers of Physicians
·         National Society of Genetic Counselors (for Category 2 credit)
·         Oman Medical Specialty Board
·         Qatar Council for Healthcare Practitioners
·         Royal College of Physicians and Surgeons of Canada (RCPSC)

Summary
Availability: On-Demand
Cost: FREE
Credit Offered:
0.25 ACE Credit
0.25 COP Credit
0.25 ABIM-MOC Point
0.25 ABP-MOC Point
Recommended
  Heart Rhythm Society
1325 G Street NW, Suite 500
Washington, DC 20005
P: 202-464-3400 F: 202-464-3401
E: questions@heartrhythm365.org
© Heart Rhythm Society
Privacy Policy | Linking Policy | Patient Education Disclaimer | State Nonprofit Disclosures | FAQ
 
Android App Download IOS App Download Powered By