State of Care of Egyptian Patients Post CRT Implantation in Heart Failure Patients.

Background: Heart failure (HF) is a prevalent clinical syn-drome classified by ejection fraction (EF) into reduced (HFrEF), mildly reduced (HFmrEF), preserved (HFpEF), and improved EF. Cardiac resynchronization therapy (CRT) improves left ventricular (LV) synchrony, reducing symptoms and enhancing survival. However, optimizing post-implantation management remains essential to ensure favorable outcomes. Aim of Study: To assess the state of care of patients post im-plantation regarding optimization of therapy and improvement of clinical status. Patients and Methods: A cross-sectional study was con-ducted on 50 HF patients post-CRT implantation. Patients underwent clinical and echocardiographic evaluation before and after implantation, assessing New York Heart Association (NYHA) class, EF, QRS width, and LV dimensions at baseline, 3, and 6 months. Device-related parameters, including LV and RV lead positioning, were analyzed. Results: The cohort (50) (80% male, mean age 66.26 ± 8.33 years) showed significant post-CRT improvements. NYHA Grade I increased from 4% to 90%, while Grades III and IV declined from 38% and 52% to 0% (p<0.001). QRS duration reduced from 148.12±17.13 ms to 125.04±15.61 ms (p<0.001), with 92% showing a decrease. EF improved from a median of 29.0% (IQR: 25.0-33.0) to 38.5% (IQR: 34.0-41.0) (p<0.001). LV lead placement was predominantly mid-lateral (84%), and RV leads were primarily apical (94%). Conclusions: CRT significantly enhances functional capac-ity and cardiac function in HF patients. Optimization of therapy through patient selection, lead positioning, and systematic fol-low-up is crucial for maximizing benefits.