A novel prediction model for survival in individual patients with cardiac resynchronization therapy with a defibrillator: Analysis of the new Japan cardiac device treatment registry database

Abstract

Background

Accurate prediction for survival in individualized patients with cardiac resynchronization therapy with a defibrillator (CRT-D) is difficult.

Methods

We analyzed the New Japan cardiac device treatment registry (JCDTR) database to develop a survival prediction model for CRT-D recipients.

Results

Four hundred and eighty-two CRT-D recipients, at the implantation year 2018–2021, with a QRS width ≥120 ms and left ventricular ejection fraction (LVEF) ≤35% at baseline, were analyzed. During an average follow-up of 21 ± 10 months, death occurred in 66 of 482 CRT-D patients (14%). A prediction model estimating annual survival probability was developed using Cox regression with internal validation. With seven explanation predictors (age >75 years, serum creatinine >1.4 mg/dL, blood hemoglobin <12 g/dL, heart rate ≥90/min, LVEF, prior NSVT, and QRS width <150 ms), the model distinguished patients with and without all-cause death, with an optimism-corrected C-statistics of 0.766, 0.764, and 0.768, and calibration slope of 1.01, 1.00, and 1.00 at 1 year, 2 years, and 3 years. Additionally, we have devised the calculator of survival probability for individual CRT-D recipients.

Conclusions

Using routine available variables, we have developed a survival prediction model for individual CRT-D recipients.