Is Cardiac Resynchronization Therapy Beneficial in Milder Heart Failure?

Evidence does not yet warrant expansion of indications for device therapy to patients with milder disease.

Cardiac resynchronization therapy (CRT), either with or without implantable defibrillators, improves outcomes in patients with severe heart failure (HF; NYHA Class III or IV), left ventricular systolic dysfunction, and increased QRS duration as determined by electrocardiograms (JW Jul 16 2004). But what about milder HF? In this study, CRT devices were placed in 610 patients with NYHA Class I or II HF who previously had exhibited symptoms of HF, systolic dysfunction (ejection fraction, ≤40%), and increased QRS duration; patients subsequently were randomized to having their devices on or off.

The primary endpoint (worsening on a clinical composite HF score) did not differ significantly between the CRT-on and CRT-off groups (16% and 21%). Howev…

Reviewing Author

Kirsten E. Fleischmann, MD, MPH

Disclosures

Grant/Research SupportNational Institutes of Health

Leadership Positions in Professional SocietiesAmerican College of Cardiology/American Heart Association

Kirsten E. Fleischmann, MD, MPH

Disclosures

Grant/Research SupportNational Institutes of Health

Leadership Positions in Professional SocietiesAmerican College of Cardiology/American Heart Association