Cardiac Resynchronization Therapy to Prevent Heart Failure: A Step Toward the Future?

Cardiac resynchronization therapy (CRT) improves heart failure symptoms in patients with low LV ejection fraction, wide QRS interval, and NYHA class III to IV heart failure. The REVERSE and MADIT-CRT trials are testing whether such benefits might extend to patients with less-severe heart failure. The 12-month results of REVERSE, the smaller of the two, have now been published. In this international trial, 610 patients with NYHA class I or II heart failure, QRS duration of ≥120 ms, and LVEF of ≤40% received a CRT device with (83%) or without (17%) an implantable cardioverter-defibrillator. The investigators then randomized the participants 2:1 to the CRT-on or CRT-off setting.

After 12 months of follow-up, the primary endpoint — absence of wo…