Cardiac resynchronization therapy improves clinical parameters, reduces hospitalizations, and lowers mortality in heart failure patients with EF <30%, NYHA class III/IV, and QRS >120 ms.
Does cardiac resynchronization therapy improve clinical outcomes, hospitalizations, and mortality in patients with congestive heart failure (EF <30%, NYHA class III/IV, QRS >120 ms)?
Cardiac resynchronization therapy is a potent therapeutic option that improves symptoms, reduces hospitalizations, and lowers mortality in symptomatic heart failure patients with reduced ejection fraction and wide QRS.
In the past decade, cardiac resynchronization therapy (CRT), achieved by simultaneous left and right ventricular pacing, has emerged as a potent therapeutic option for patients with congestive heart failure. Electrical dyssynchrony, most often manifested by left bundle branch block on the surface 12-lead electrocardiogram, results in mechanical dyssynchrony of the left ventricular septum and free wall, which decreases cardiac efficiency. In patients with ejection fractions 120 ms, CRT improves clinical parameters such as 6-minute walk distances, quality-of-life scores, and NYHA functional class. Long-term reverse remodeling of the failing ventricle results in reductions in congestive heart failure hospitalizations and mortality independent of defibrillator therapy. While most patients show significant improvement, a small proportion fail to respond. Appropriately identifying patients who will benefit most from CRT and timing the initiation of resynchronization therapy remain areas of intense investigation.
Mark et al. (Thu,) conducted a review in Congestive heart failure. Cardiac resynchronization therapy (CRT) was evaluated. Cardiac resynchronization therapy improves clinical parameters, reduces hospitalizations, and lowers mortality in heart failure patients with EF <30%, NYHA class III/IV, and QRS >120 ms.