March 15, 2011Annals of Internal Medicine
Meta-analysis: Cardiac Resynchronization Therapy for Patients With Less Symptomatic Heart Failure
Why the study?
Does cardiac resynchronization therapy reduce mortality and heart failure hospitalizations in adults with heart failure and LVEF ≤0.40?
Population
9,082 adults with heart failure and a left ventricular ejection fraction of 0.40 or less across 25 trials
Comparison
Cardiac resynchronization therapy (CRT) vs Usual care and right or left ventricular pacing
Design
Meta-analysis
Authors
Discussion
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Implication
Supports CRT across NYHA classes in HFrEF; confirms mortality and hospitalization reductions irrespective of symptom severity.
Structured PICO
Does cardiac resynchronization therapy reduce mortality and heart failure hospitalizations in adults with heart failure and LVEF ≤0.40?
P
Population
9,082 adults with heart failure and a left ventricular ejection fraction of 0.40 or less across 25 trials
I
Intervention
Cardiac resynchronization therapy (CRT)
C
Comparator
Usual care and right or left ventricular pacing
O
Outcome
All-cause mortality and heart failure hospitalizationshard clinical
Cardiac resynchronization therapy reduces all-cause mortality and heart failure hospitalizations in patients with reduced ejection fraction, regardless of whether they have advanced or less symptomatic disease.
Limitations
- Subgroup analyses were underpowered
- Lack data for persons with NYHA class I symptoms, atrial fibrillation, chronic kidney disease, or right bundle branch block
Cite This Study
Al-Majed et al. (2011) studied this question.