Life expectancy in patients with chronic heart failure, atrial fibrillation and implantable cardiac contractility modulation devices

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Background. Combination of chronic heart failure (CHF) and atrial fibrillation (AF) is common and followed by high mortality. Therefore, assessing the impact of treatment on prognosis of this disease is important. Objective. To evaluate life expectancy in patients with CHF with reduced left ventricular ejection fraction, AF and implantable cardiac contractility modulation devices compared to MAGGIC risk score. Material and methods. A prospective study included 100 patients with implantable cardiac contractility modulation devices. The follow-up was 3 years. Considering literature data, we constructed the model for prediction of mortality in our patients using the MAGGIC score. We calculated hypothetical life expectancy without cardiac contractility modulation devices and actual life expectancy after implantation of these devices using the generally accepted method. Results. Implantation of cardiac contractility modulation devices significantly (p<0.001) increased actual life expectancy compared to hypothetical value (6.15 (95% CI 4.37—7.18) and 5.92 (95% CI 4.35—6.69) years for the first and third years of follow-up, respectively). The estimated life expectancy was 4.42 (95% CI 3.37—5.82) and 3.85 (95% CI 2.81—5.18) years, respectively. Conclusion. Cardiac contractility modulation devices are effective and safe in patients with CHF and AF. The proposed method of life expectancy analysis makes it possible to justify prolongation of life expectancy in these patients.

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