| Which patients with chronic heart failure should be referred for CRT-D implantation? Practical implications of current clinical research. | |
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MedLine Citation:
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PMID: 20332716 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Over the last decade, cardiac resynchronization therapy (CRT) has emerged as an important treatment modality in patients with heart failure. Primary prevention of mortality with implantable cardioverter-defibrillator (ICD) in patients with ischemic and nonischemic cardiomyopathy and left ventricular dysfunction (ejection fraction [EF] < or =35%) has become the standard of care. A growing number of patients with indications for ICD are also eligible for CRT, receiving resynchronization pacing-defibrillator devices (CRT-D). Randomized clinical trials have provided evidence that cardiac resynchronization therapy is beneficial in heart failure patients and contributes to a significant decrease in heart failure progression on top of administering optimal pharmacological therapy. Currently approved indications for CRT-D include utilizing this treatment modality in heart failure patients with New York Heart Association (NYHA) class III or IV, EF < or =35%, and QRS > or =120 ms. New data from MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy) document that patients with less advanced heart failure (ischemic cardiomyopathy in NYHA class I or II and nonischemic cardiomyopathy class II), EF < or =30%, and QRS > or =130 ms also benefit from CRT. These findings indicate that a more proactive approach should be considered regarding the management of heart failure patients with less advanced disease to decrease progression of heart failure with CRT-D therapy. |
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Authors:
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Wojciech Zareba; Karolina M Zareba |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Polskie Archiwum Medycyny Wewnętrznej Volume: 120 ISSN: 1897-9483 ISO Abbreviation: Pol. Arch. Med. Wewn. Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-24 Completed Date: 2010-07-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401225 Medline TA: Pol Arch Med Wewn Country: Poland |
Other Details:
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Languages: eng Pagination: 95-102 Citation Subset: IM |
Affiliation:
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Cardiology Division, University of Rochester Medical Center, Rochester, New York, USA. wojciech_zareba@urmc.rochester.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Pacing, Artificial* Defibrillators, Implantable* Heart Failure / therapy* Humans Pacemaker, Artificial* Referral and Consultation Severity of Illness Index |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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