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Complications of Cardiac Resynchronization Therapy: Comparison of Safety Outcomes from Real-world Studies and Clinical Trials

Cardiac resynchronization therapy (CRT) is an important intervention in heart failure. Whether real-world complication rates mirror those reported in randomized clinical trials (RCTs) is unknown. We sought to compare rates of procedural complications between major RCTs of CRT with “real-world” compl...

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Autores principales: Pothineni, Naga Venkata K., Gondi, Suhas, Cherian, Tharian, Kovelamudi, Swathi, Schaller, Robert D., Lakkireddy, Dhanunjaya, Gopinathannair, Rakesh, Deshmukh, Abhishek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MediaSphere Medical 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9436403/
https://www.ncbi.nlm.nih.gov/pubmed/36072440
http://dx.doi.org/10.19102/icrm.2022.130805
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author Pothineni, Naga Venkata K.
Gondi, Suhas
Cherian, Tharian
Kovelamudi, Swathi
Schaller, Robert D.
Lakkireddy, Dhanunjaya
Gopinathannair, Rakesh
Deshmukh, Abhishek
author_facet Pothineni, Naga Venkata K.
Gondi, Suhas
Cherian, Tharian
Kovelamudi, Swathi
Schaller, Robert D.
Lakkireddy, Dhanunjaya
Gopinathannair, Rakesh
Deshmukh, Abhishek
author_sort Pothineni, Naga Venkata K.
collection PubMed
description Cardiac resynchronization therapy (CRT) is an important intervention in heart failure. Whether real-world complication rates mirror those reported in randomized clinical trials (RCTs) is unknown. We sought to compare rates of procedural complications between major RCTs of CRT with “real-world” complication rates reported in registries and administrative claims database studies. We conducted a PubMed search to identify all relevant publications on CRT and classified them into RCTs and registry studies. Pooled procedural complication rates were analyzed. Differences between groups were compared using the chi-squared test. We identified a total of 6 RCTs, 2 administrative claims database studies, and 4 CRT registry studies. RCTs included a total of 4,442 patients and “real-world” studies included a total of 72,554 patients. The overall rates of procedural complications with CRT were significantly higher in RCTs compared to the real world (8.1% vs. 6.9%, P = .002). Lead-related complications were higher in the real-world studies compared to RCTs (11.3% vs. 6.5%, P = .0001). This could represent a follow-up bias with patients in registries being followed up for longer durations that would compound lead complication rates. Interestingly, RCTs had a higher incidence of pocket hematomas (2.1% vs. 0.4%, P = .001). In conclusion, real-world procedural complication rates of CRT appear to be significantly lower than those reported in RCTs.
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spelling pubmed-94364032022-09-06 Complications of Cardiac Resynchronization Therapy: Comparison of Safety Outcomes from Real-world Studies and Clinical Trials Pothineni, Naga Venkata K. Gondi, Suhas Cherian, Tharian Kovelamudi, Swathi Schaller, Robert D. Lakkireddy, Dhanunjaya Gopinathannair, Rakesh Deshmukh, Abhishek J Innov Card Rhythm Manag Research Review Cardiac resynchronization therapy (CRT) is an important intervention in heart failure. Whether real-world complication rates mirror those reported in randomized clinical trials (RCTs) is unknown. We sought to compare rates of procedural complications between major RCTs of CRT with “real-world” complication rates reported in registries and administrative claims database studies. We conducted a PubMed search to identify all relevant publications on CRT and classified them into RCTs and registry studies. Pooled procedural complication rates were analyzed. Differences between groups were compared using the chi-squared test. We identified a total of 6 RCTs, 2 administrative claims database studies, and 4 CRT registry studies. RCTs included a total of 4,442 patients and “real-world” studies included a total of 72,554 patients. The overall rates of procedural complications with CRT were significantly higher in RCTs compared to the real world (8.1% vs. 6.9%, P = .002). Lead-related complications were higher in the real-world studies compared to RCTs (11.3% vs. 6.5%, P = .0001). This could represent a follow-up bias with patients in registries being followed up for longer durations that would compound lead complication rates. Interestingly, RCTs had a higher incidence of pocket hematomas (2.1% vs. 0.4%, P = .001). In conclusion, real-world procedural complication rates of CRT appear to be significantly lower than those reported in RCTs. MediaSphere Medical 2022-08-15 /pmc/articles/PMC9436403/ /pubmed/36072440 http://dx.doi.org/10.19102/icrm.2022.130805 Text en Copyright: © 2022 Innovations in Cardiac Rhythm Management https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Review
Pothineni, Naga Venkata K.
Gondi, Suhas
Cherian, Tharian
Kovelamudi, Swathi
Schaller, Robert D.
Lakkireddy, Dhanunjaya
Gopinathannair, Rakesh
Deshmukh, Abhishek
Complications of Cardiac Resynchronization Therapy: Comparison of Safety Outcomes from Real-world Studies and Clinical Trials
title Complications of Cardiac Resynchronization Therapy: Comparison of Safety Outcomes from Real-world Studies and Clinical Trials
title_full Complications of Cardiac Resynchronization Therapy: Comparison of Safety Outcomes from Real-world Studies and Clinical Trials
title_fullStr Complications of Cardiac Resynchronization Therapy: Comparison of Safety Outcomes from Real-world Studies and Clinical Trials
title_full_unstemmed Complications of Cardiac Resynchronization Therapy: Comparison of Safety Outcomes from Real-world Studies and Clinical Trials
title_short Complications of Cardiac Resynchronization Therapy: Comparison of Safety Outcomes from Real-world Studies and Clinical Trials
title_sort complications of cardiac resynchronization therapy: comparison of safety outcomes from real-world studies and clinical trials
topic Research Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9436403/
https://www.ncbi.nlm.nih.gov/pubmed/36072440
http://dx.doi.org/10.19102/icrm.2022.130805
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