Sérgio Barra, cardiologist from Hospital da Luz Arrábida, is the main author of a scientific article that has just been published in the renowned “European Heart Journal”, the official magazine of the European Society of Cardiology and presently the journal with higher impact in the area. The article, that is based on a European observational multicentric study, approaches the treatment of cardiac resynchronization, destined for patients with cardiac insufficiency, left ventricular dysfunction and electrical dyssynchrony (with subsequent mechanical dyssynchrony). Read the article published on July 7, under the title of “Very long-term survival and late sudden cardiac death in cardiac resynchronization therapy patients”. Previous studies showed that the therapy of cardiac resynchronization (CRT) allows to reduce the risk of hospitalization for cardiac insufficiency, as well as to improve the quality of life of patients and reduce the global risk of mortality. CRT consists in the insertion of a device in the thorax, under the skin, to resynchronize the left ventricle and thus improve the functioning of the heart. The device can be inserted isolated (CRT-P) or combined with a defibrillator (implantable cardioverter defibrillator, designated CRT-D). Since the latter is a more expensive device and associated to a higher risk of complications, it is important to realize if it really brings a prognostic benefit, when compared with the former, singly implanted. The article by Sérgio Barra, with other 21 foreign specialist co-authors, describes an observational multicentric study, involving dozens of hospital centres in England, France, Czech Republic and Sweden, and over 3000 patients submitted to cardiac resynchronization, with or without defibrillator, having accomplished at least five years of follow-up. After those five years, these patients were followed-up to assess the risk of mortality at very long term, causes of death and eventual benefit of the defibrillator. “The study showed that, at very long term, the presence of a defibrillator does not grant a significant prognostic benefit, when compared with isolate CRT. In patients with CRT alive at the end of the first five years after the implant, the most frequent cause of death results from cardiac insufficiency, while sudden death represents a very small percentage of cases, independently of the presence / absence of a defibrillator”, it is stated in the conclusions. Sérgio Barra is also cardiologist in the Hospital da Luz units of Amarante, Cerveira, Guimarães and Porto.
