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Heart-failure patients are at high risk for both sudden death and rehospitalization for heart failure. In two randomized trials, researchers explored how these outcomes were affected by cardiac resynchronization therapy (CRT) with biventricular pacemakers and by implantable cardioverter-defibrillator (ICD) therapy.
In one trial, 1520 patients with NYHA class III-IV heart failure (either ischemic or nonischemic), ejection fractions ≤35%, and electrocardiographically measured QRS complexes ≥120 msec were randomized to receive optimal medical therapy (OMT) alone, OMT plus CRT (with biventricular pacing), or OMT plus CRT plus ICD therapy. At 1 year, the composite rate of death and rehospitalization for any cause was significantly lower with CRT …