Cardiac Resynchronization Therapy for Mild-to-Moderate Heart Failure

Cardiac resynchronization therapy plus an implantable cardioverter-defibrillator (CRT-D) is lifesaving and cost-effective in patients with congestive heart failure (CHF) class III or IV. CRT-D also decreases mortality, reduces hospitalizations, and improves quality of life in those with less-severe CHF such as class I and II, but cost-effectiveness in this population has been more difficult to assess. Now, researchers have developed a complicated Markov model, based largely on data from the RAFT and MADIT-CRT studies, to assess the impact of CRT on cost-effectiveness in CHF class I and II. They derived the model from patients ≥65 years, left ventricular ejection fraction ≤30%, QRS duration of ≥120 ms, and CHF class I or II. Unlike RAFT and …