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

emakers 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."


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

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