Document Detail

Assessment of resynchronization therapy on functional status and quality of life in patients requiring an implantable defibrillator.
MedLine Citation:
PMID:  19765233     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The effect of cardiac resynchronization therapy (CRT) on physical function and Quality of Life (QoL) in patients who require an implantable defibrillator but do not meet guideline criteria for CRT has not been studied in detail. METHODS AND RESULTS: This was a randomized study of 72 patients with high risk of sudden cardiac death, ejection fraction (EF) < or =35%, mild-to-moderate heart failure symptoms, and QRS > 120 ms. Patients received a CRT defibrillator and were randomized to CRT turned ON or OFF. Objective and subjective measures were performed at baseline and after 6 months. There was no difference in change in left ventricular end-systolic volume (ESV) by radionuclid angiogram scan, the primary endpoint, between the CRT ON group (DeltaESV =-7 +/- 52 mL), and CRT OFF group (DeltaESV =-30 +/- 47 mL). Similarly, echocardiogram measures of ESV and EF showed no difference between the two groups. In the CRT ON group, selected measures of QoL and subjective exercise tolerance but not heart failure symptoms improved significantly. Six-minute walk distance prolonged in the CRT ON group (baseline 313.6 +/- 114.4 m, 6-month 365.0 +/- 122.5 m, P = 0.01), but the difference in change in walk distance between the two groups was not significant. CONCLUSION: Further studies with larger sample size and longer follow-up will be required to allow definite conclusions regarding the potential benefit of CRT in this patient population.
Arnold Pinter; Iqwal Mangat; Victoria Korley; Stuart Connolly; Sean Connors; Martin Gardner; Francois Philippon; Larry Sterns; Bernard Thibault; Paul Dorian
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-09-17
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  32     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-05-06     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1509-19     Citation Subset:  IM    
Department of Medicine, Division of Cardiology, University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada.
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MeSH Terms
Aged, 80 and over
Cardiac Pacing, Artificial*
Defibrillators, Implantable*
Follow-Up Studies
Gated Blood-Pool Imaging
Heart Failure / physiopathology*,  therapy*
Middle Aged
Quality of Life*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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