Navigation Links
Pacemaker implantation for heart failure does not benefit nearly half of the patients
Date:6/13/2011

A new meta-analysis study, led by physician researchers at University Hospitals (UH) Case Medical Center and Case Western Reserve University School of Medicine, and to be published in the Archives of Internal Medicine (embargoed until June 13, 4 p.m. EDT), shows that three-lead cardiac pacemakers implanted in those with heart failure fail to help up to 40 percent of patients with such devices.

"These findings have significant clinical implications and impact tens of thousands of patients in the U.S.," said Ilke Sipahi, MD, Associate Director of Heart Failure and Transplantation at UH Case Medical Center and Assistant Professor at Case Western Reserve University School of Medicine. "In this in-depth analysis, we found that pacemaker patients with less severe electrical disturbance in their hearts did not receive any benefit whatsoever from these expensive and potentially risky implants. Given the abundance of data showing lack of efficacy in this patient population, current treatment guidelines should be changed."

Dr. Sipahi, along with James Fang, MD, Director, Clinical Cardiovascular Services at UH Case Medical Center and Professor at Case Western Reserve University School of Medicine, investigated the treatment method known as cardiac resynchronization therapy (CRT). This highly sophisticated treatment technique involves pacing both ventricles of the heart in an attempt to correct the impaired synchrony during contraction of the heart.

Sometimes also referred to as "biventricular pacing," CRT is a form of therapy for congestive heart failure that utilizes a special pacemaker to re-coordinate the action of the heart chambers.

The study is a combined analysis of clinical trials of nearly 6,000 patients and examines whether the current criteria used by the medical community in selecting patients for the treatment are appropriate.

Treatment guidelines endorsed by various professional societies recommend these pacemakers for patients with heart failure symptoms due to weak heart muscles that have a specific abnormality on the electrocardiogram (EKG) known as QRS prolongation. Current treatment guidelines recommend that heart failure patients with QRS prolongation to greater than 0.12 seconds should get these devices.

However, the new meta-analysis demonstrates that patients do not have a survival benefit or a reduction in hospitalizations from these pacemakers, unless their QRS is prolonged to greater than 0.15 seconds, a threshold much greater than the 0.12 second cutoff advocated in the treatment guidelines. Approximately 40 percent of patients receiving these devices have a QRS prolongation in the range of 0.12 to 0.15 seconds and do not get any benefit from pacemaker therapy according to the results of the new study.

"This study can have profound impact on minimizing unnecessary procedures" added Dr. Sipahi. "Revising the criteria for implantation of these devices will help avoid thousands of unnecessary implants and will also lead to cutting down on unwarranted costs."

In contrast, the tandem's research also confirmed that patients with QRS prolongation greater 0.15 seconds got substantial benefit from their devices, lived longer and were hospitalized less often.

Heart failure, especially at its advanced stages, is a deadly disease affecting approximately 6 million Americans. Annual costs related to heart failure approached $40 billion in 2010. The global CRT devices market is expected to reach at $2.8 billion by 2015 with the North American segment accounting for nearly 40 percent of the global value.

"Our analysis suggests that this important therapy appears to benefit primarily those patients with the greatest prolongation in the QRS duration," said Fang. "This study may help to better select patients who are most likely to benefit from this effective but costly procedure."


'/>"/>

Contact: Mike Ferrari
mike.ferrari@uhhospitals.org
216-844-7239
University Hospitals Case Medical Center
Source:Eurekalert

Related medicine news :

1. Keep MP3 Headphones 2 Centimeters or More From Pacemaker: Study
2. Could Stomach Pacemaker Be New Weight-Loss Tool?
3. FDA Approves First Pacemaker Deemed Safe During MRIs
4. Brain pacemakers: A long-lasting solution in the fight against depression
5. Pacemakers May Help Predict Strokes
6. Recycling pacemakers may alleviate burden of heart disease across the globe
7. Studies show everolimus-eluting stent implantation reduces restenosis and repeat revasculariztion
8. Ear Tubes Appear to Be Safe Before Cochlear Implantation
9. Medical Groups Update Heart, Blood Pressure Care Guidelines
10. 1 in 5 heart-attack deaths could be prevented with new drug
11. Heart Attack Victims Face Greater Risk of Dying When Ambulances Are Diverted
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/25/2017)... ... April 25, 2017 , ... As President ... are preparing for how his administration could impact the employee benefits industry. James ... changes are most likely to make it through Congress. His discussion will focus ...
(Date:4/25/2017)... ... April 25, 2017 , ... ... on contracted partners to help with process innovation in drug formulation and manufacturing. ... experience along with state-of-the-art analytical equipment in support of their development and manufacturing ...
(Date:4/25/2017)... ... April 25, 2017 , ... Somnoware, a leading provider of ... management module. Using this new feature, sleep physicians can now predict the likelihood ... positive airway pressure (CPAP), oral, or other forms of sleep apnea therapy. The ...
(Date:4/24/2017)... ... ... Emmanuel College is introducing enhancements to its RN-to-BSN Degree Program ... of 2017, Emmanuel’s program will allow registered nurses (RN)s to earn a Bachelor of ... little as $14,528. These changes will enable nurses to complete their degree in a ...
(Date:4/24/2017)... , ... April 24, 2017 , ... As part of ... today to honor the victims of the Holocaust and Nazi persecution, Center for ... Hadamar and Auschwitz on its CMATH Champions trip to Germany and Poland next week. ...
Breaking Medicine News(10 mins):
(Date:4/20/2017)... Mass. , April 20, 2017  RXi ... developing innovative therapeutics that address significant unmet medical ... data from the Company,s consumer product development program, ... at the Society for Investigative Dermatology (SID) 76 ... to advance and promote the sciences relevant to ...
(Date:4/20/2017)... Research and Markets has announced the addition of ... Regional Outlook, Growth Trends, Key Players, Competitive Strategies and Forecasts, ... ... at US$ 7,167.6 Mn in 2015, and is expected to ... of 5.6% from 2016 to 2024. The ...
(Date:4/19/2017)... April 19, 2017 Cardiology devices segment is anticipated ... The Cardiology Devices segment is likely to create ... Mn in 2018 over 2017. By the end of 2027, ... close to US$ 700 Mn, expanding at a CAGR of ... the Asia Pacific reprocessed medical devices ...
Breaking Medicine Technology: