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May 1, 2004Journal of Cardiac Surgery

Cardiac Resynchronization Therapy:. Device-Based Medicine for Heart Failure

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Key result

Cardiac resynchronization therapy combined with an ICD reduces the composite endpoint of all-cause mortality and hospitalization by 43% in patients with advanced heart failure.

Why the study?

Does cardiac resynchronization therapy improve outcomes in patients with advanced heart failure, reduced LV function, and wide QRS?

Population

Patients with advanced heart failure, reduced LV function, wide QRS, and symptomatic refractory HF despite…

Design

Review

Authors

FPFrançois Philippon

Discussion

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Overview

May support CRT-D consideration in advanced HF with wide QRS; leaves open need for contemporary RCTs.

Structured PICO

Does cardiac resynchronization therapy improve outcomes in patients with advanced heart failure, reduced LV function, and wide QRS?

P
Population
Patients with advanced heart failure, reduced LV function, wide QRS (>120 ms), and symptomatic refractory HF despite optimal drug therapy.
I
Intervention
Cardiac resynchronization therapy (CRT) or biventricular pacing, with or without an implantable cardiac defibrillator (ICD).

CRT is an effective adjunctive device therapy for patients with advanced, symptomatic heart failure, reduced ejection fraction, and wide QRS despite optimal medical therapy.

Limitations

  • Unanswered questions regarding the nonresponder population
  • Role of tissue Doppler imaging techniques
  • Impact of CRT on total mortality
  • Efficacy of CRT in dilated cardiomyopathy or chronic atrial fibrillation
  • Efficacy in dilated cardiomyopathy or chronic atrial fibrillation

Cite This Study

François Philippon (2004) conducted a review in Advanced heart failure. Cardiac resynchronization therapy (CRT) was evaluated. Cardiac resynchronization therapy combined with an ICD reduces the composite endpoint of all-cause mortality and hospitalization by 43% in patients with advanced heart failure.

synapsesocial.com/papers/6a9b54992e0551cedd882919https://doi.org/10.1111/j.0886-0440.2004.04081.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial.2003 · 1,629 citations
  2. 2Acute effects of cardiac resynchronization therapy on functional mitral regurgitation in advanced systolic heart failure2003 · 519 citations
  3. 3Effect of Resynchronization Therapy Stimulation Site on the Systolic Function of Heart Failure Patients2001 · 630 citations
  4. 4Evaluation of Different Ventricular Pacing Sites in Patients With Severe Heart Failure1997 · 644 citations
  5. 5Predictors of Systolic Augmentation From Left Ventricular Preexcitation in Patients With Dilated Cardiomyopathy and Intraventricular Conduction Delay2000 · 368 citations