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Information on cardiac resynchronization therapy (crt), specifically biventricular pacing, and its effects on heart failure patients. Details from various studies such as miracle icd and companion, which examine the benefits of crt in reducing the risk of death and hospitalization. The care hf study is also discussed, which focuses on the effect of crt on mortality and morbidity in patients with heart failure and dysynchrony. The document concludes with the latest crt guidelines.
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68% composite end point in pharacological group.
56% in BIV alone
56% in ICD + BIV group.
Pharmacological 19%
BIV (hazard ration of .76, CI of .58 to 1.01, p 0.059) –
near significant
BIV ICD: 36% reduction, Hazard ratio .64, CI .48 to .86,
P0.
NYHA Class III or IV
LVEF < 35%
QRS > 150, or 120 w/ other signs of dyssynchrony
by echo.
20% vs 30%. Biggest finding is that
this drop was found to mostly be in less
deaths from worsening heart failure.
Shows the benefits of Bi Ventricular pacing
and CRT alone in survival in HF.
CARE HF Hemodynamic, Echocardiographic, and Biochemical Assessments
Cleland, J. et al. N Engl J Med 2005;352:1539-
Cardiac Resynchronization Therapy*
in Patients With Severe Systolic
Heart Failure
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*All primary SCD prevention ICD recommendations apply only to patients who are receiving optimal medical therapy and have reasonable expectation
of survival with good functional capacity for more than 1 year.