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CRT-D better than CRT-P in NIDCM with left ventricular midwall fibrosis

Francisco Leyva and colleagues compared the outcomes of cardiac resynchronization therapy with (CRT-D) or without defibrillation (CRT-P) in non ischemic cardiomyopathy (NIDCM) [1]. Of their 252 patients, 68 had left ventricular midwall fibrosis detected by cardiac magnetic resonance imaging (CMR). It was found that left ventricular mid wall fibrosis was an independent predictor of total mortality, death from pump failure and sudden cardiac death. Maximum follow up period in their study was 14 years. They documented lower total mortality or hospitalization for major adverse cardiac events in those with CRT-D compared with CRT-P in those with left ventricular mid wall fibrosis. This was not observed in those without left ventricular mid wall fibrosis. The find would favour usage of CRT-D over CRT-P in NIDCM with left ventricular mid wall fibrosis.


  1. Leyva F, Zegard A, Acquaye E, Gubran C, Taylor R, Foley PWX, Umar F, Patel K, Panting J, Marshall H, Qiu T. Outcomes of Cardiac Resynchronization Therapy With or Without Defibrillation in Patients With Nonischemic Cardiomyopathy. J Am Coll Cardiol. 2017 Sep 5;70(10):1216-1227.
MCQs in Medicine - Cardiovascular System is based on undergraduate medical curriculum. Though the questions are aimed at basic post graduate entrance examinations, candidates taking competitive exams at the post graduate exit level may also find them useful, especially the explanations for the answers. Undergraduate medical students will find them useful for answering MCQ tests in their regular exams. More than just answering MCQs, the explanations will improve the knowledge and understanding about the conditions discussed.Medicine MCQs - Cardiovascular System Kindle Edition: Click Here for a Preview Comments and suggestions are most welcome.