Use and Outcomes of Dual Chamber or Cardiac Resynchronization Therapy Defibrillators Among Older Patients Requiring Ventricular Pacing in the National Cardiovascular Data Registry Implantable Cardioverter Defibrillator Registry

Key Points Question Among patients undergoing implantable cardioverter defibrillator (ICD) implantation who are likely to require frequent right ventricular pacing, what are the outcomes of cardiac resynchronization therapy (CRT) compared with a dual chamber device, what is the variability in use of device type, and what are the trends in use of device type over time? Findings In this cohort study of 3100 Medicare patients undergoing first-time ICD implantation with a ventricular bradycardia pacing indication, the use of CRT was associated with a lower risk of heart failure hospitalization and 1-year mortality without an increase in procedural complications compared with a dual chamber device. Variability in use of device type was observed, and the rate of CRT implantation increased over time. Meaning In this study, CRT was associated with better outcomes than dual chamber devices among adult patients.

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