Document Detail


Which patients with chronic heart failure should be referred for CRT-D implantation? Practical implications of current clinical research.
MedLine Citation:
PMID:  20332716     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Wojciech Zareba; Karolina M Zareba
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Polskie Archiwum Medycyny Wewnętrznej     Volume:  120     ISSN:  1897-9483     ISO Abbreviation:  Pol. Arch. Med. Wewn.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-24     Completed Date:  2010-07-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401225     Medline TA:  Pol Arch Med Wewn     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  95-102     Citation Subset:  IM    
Affiliation:
Cardiology Division, University of Rochester Medical Center, Rochester, New York, USA. wojciech_zareba@urmc.rochester.edu
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MeSH Terms
Descriptor/Qualifier:
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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