Abstract 4143153: Correlation Between CRT Response and Patient-Reported Outcomes in Heart Failure with Reduced Ejection Fraction Patients

Background: The correlation between CRT response and patient-reported outcomes is uncertain. Objective: To identify whether patient reported outcomes correlate with CRT response through a decision regret scale (DRS) in patients with heart failure with reduced ejection fraction (HFrEF). Hypothesis: CRT non-responders have more regret over having undergone device implant compared with responders. Methods: We included a total of 150 patients with HFrEF who underwent CRT implantation at the Cleveland Clinic from 2020-2022. Each patient was given a DRS questionnaire at 6 months post-CRT implant, and their CRT response status was assessed echocardiographically. Response was defined as an improvement in LVEF >5% with reduction in LVESV>10%. Patients were unaware of their response status at the time of filling out the questionnaire. The DRS Questionnaire asks patients whether they regret their decision to undergo a procedure. Patients rated, on a scale of 1 (strongly agree) to 5 (strongly disagree)- their agreement with five statements: It was the right decision; I regret the choice that I made; I would go for the same choice again; The choice did me a lot of harm; and The decision was a wise one. We grouped questions 1,3, and 5 from the DRS together for positive score (higher is more regret), and questions 2 and 4 were grouped together for negative score (lower is more regret). This data was compared between 2 groups based on responder (107; 71.33%) and non-responder status (43; 28.67%). Results: The median IQR positive score and negative score among all patients was 3 (3-5), and 10 (8-10) respectively. There were no patients who voiced significant regret for having undergone device implant. In comparing the scores between responders and non-responders, the Mann-Whitney U test revealed no difference in scores. [Median IQR positive score 3 (3-6) in non-responders, 3 (3-4.5) in responders; p=0.19; negative score 10 (8-10) non-responders,10 (9-10) in responders; p=0.44] (Figure 1). Conclusion: Patients with HFrEF undergoing CRT overwhelmingly do not regret their decision to undergo device implantation. The presence or absence of significant remodeling had no impact on patient satisfaction feelings towards the decision to undergo device implantation.