A Meta-Analysis of Two Double-Blind, Placebo Controlled, Randomized Trials to Evaluate the Efficacy and Safety of Carvedilol Treatment in Non-Dialysis Dependent Chronic Kidney Disease Patients with Symptomatic or Asymptomatic Systolic Heart Failure

is unclear whether patients with ICDs present differently than those with CRT when experienced threshold crossing. Methods: We reviewed a total of 137 consecutive threshold crossings (107 CRTs, 30 ICDs) between 2007-8 by an independent physician. Our program consisted of daily data review by a heart failure device nurse of regularly scheduled (3-month interval) device interrogation uploads of the Optivol . Upon a threshold crossing ($ 60 ohms, TC), a phone call was generated to inquire about clinical stability using a pre-defined set of questions to assess clinical presentation and self-care characteristics. Results: In our study cohort (mean age 78 6 3; mean LVEF 30 612%), patients with ICDs have less clinical signs and symptoms, and correspondingly fewer adherences to self-care for heart failure (see Table). Except for average night heart rate (NHR) and crossing NHR (both higher in CRT patients), all other hemodynamic values were indifferent. No significant change occurred in the maximum TI reached, number of days above the TC, admission rates, ER and outpatient visits, and time from TC and questionnaire completion. When a small sub group analysis comparing patients who had EF increase after CRT (n510) and no adjustment (n511), a higher HRV was noted in the day of the crossing. No difference in compliance, visit or admission rates in this subgroup.