Introduction: Cardiac resynchronization therapy devices (CRTs) are accepted therapies for progressive heart failure. Ethnic differences in the use of CRT with defibrillator (CRT-D) may result from underuse relative to published guidelines. We sought to evaluate ethnic disparities in implantation of CRT-Ds among Israeli patients.
Methods: Between July 2010 and June 2012 a total of 1805 consecutive patients undergoing ICD/CRT-D implantation for primary prevention of sudden cardiac death were prospectively enrolled in the Israeli ICD Registry. According to guidelines criteria a subset of 790 patients was eligible for CRT-D implantation.
Results: Arab patients (n=140; 18%) were found to be younger at the age of implantation, with higher rates of non-ischemic cardiomyopathy and complete LBBB (p value <0.05, for all). In a multivariate logistic regression model (Table) non-ischemic cardiomyopathy, NYHA class>2 and CLBBB were found to be significant independent predictors of CRT-D implantation, whereas ethnicity was not independently associated with likelihood for device implantation (Table). When assessed by heart failure etiology, eligible non-ischemic Arab patients were less likely to receive CRT-D than an ICD (OR= 0.3, p value 0.03).
Conclusion: Our findings show significant differences in the clinical characteristics of Arab and Jewish patients who are eligible for CRT-D. The overall likelihood for CRT-D implantation was similar between the two groups, with a possible difference among patients with non-ischemic cardiomyopathy.
