The prognostic predictors of death or heart failure hospitalization and the echocardiographic response after initial cardiac resynchronization therapy (CRT) device replacement (CRT-r) remain unclear. We evaluated the predictors and the echocardiographic time course in patients after CRT-r. Consecutive 60 patients underwent CRT-r because of battery depletion. Patients were divided into two groups depending on the chronic echocardiographic response to CRT (left ventricular end-systolic volume [LVESV] reduction of ≥ 15%) at the time of CRT-r: CRT responders (group A; 35 patients) and CRT nonresponders (group B; 25 patients). The primary endpoint was a composite of death from any cause or heart failure hospitalization. Changes in LVESV and left ventricular ejection fraction (LVEF) after CRT-r were also analyzed. During the mean follow-up of 46 ± 33 months after CRT-r, the primary endpoint occurred more frequently in group B (group A versus group B; 8/35 [23%] patients versus 19/25 [76%] patients, p < 0.001). No significant changes in LVESV and LVEF were observed at the mean of 46 ± 29 months after CRT-r in both groups. A multivariate analysis identified echocardiographic nonresponse to CRT, chronic kidney disease, atrial fibrillation, and New York Heart Association functional class III or IV at the time of CRT-r as independent predictors of the primary endpoint in all patients. Residual echocardiographic nonresponse, comorbidities, and heart failure symptoms at the time of CRT-r predict the subsequent very long-term prognosis after CRT-r. No further echocardiographic response to CRT was found after CRT-r.

死亡或心力衰竭住院的预后预测因子以及初始心脏再同步治疗 (CRT) 装置更换 (CRT-r) 后的超声心动图反应仍不清楚。我们评估了 CRT-r 后患者的预测因子和超声心动图时间进程。由于电池耗尽，连续 60 名患者接受了 CRT-r。根据 CRT-r 时对 CRT 的慢性超声心动图反应（左心室收缩末期容积 [LVESV] 减少 ≥ 15%）将患者分为两组：CRT 反应者（A 组；35 名患者）和 CRT 无反应者（B组；25名患者）。主要终点是全因死亡或心力衰竭住院的复合终点。还分析了 CRT-r 后 LVESV 和左心室射血分数 (LVEF) 的变化。p  < 0.001)。在 CRT-r 后平均 46 ± 29 个月，两组的 LVESV 和 LVEF 均未观察到显着变化。多变量分析确定超声心动图对 CRT 无反应、慢性肾病、心房颤动和 CRT-r 时纽约心脏协会功能分级 III 或 IV 作为所有患者主要终点的独立预测因素。CRT-r 时残留的超声心动图无反应、合并症和心力衰竭症状可预测 CRT-r 后随后的极长期预后。CRT-r 后未发现对 CRT 的进一步超声心动图反应。