Cardiac Resynchronization Therapy Faces Another Morbidity-Mortality Test

Cardiac resynchronization therapy (CRT) improves quality of life, functional status, exercise capacity, and left-ventricular structure and function in patients with chronic systolic heart failure and intraventricular conduction delays (e.g., see the MIRACLE trial, Journal Watch Cardiology Jul 26 2002). Put to the morbidity-mortality test in the COMPANION trial (Journal Watch Cardiology Jul 16 2004), CRT fared well, with or without implantable cardioverter-defibrillator (ICD) therapy, but the mortality benefit without an ICD was borderline.

Now, in the manufacturer-sponsored, unblinded CARE-HF trial, researchers randomized more than 800 medically treated NYHA class III–IV heart failure patients with LV ejection fractions ≤35% and QRS duration…