Navigation Links
The benefits of cardiac resynchronisation therapy in heart failure
Date:12/18/2011

However, large-scale clinical trials have highlighted the beneficial effect of cardiac resynchronisation therapy (CRT) in the improvement of symptoms and reduction of mortality, and CRT is now recommended in the major European and American guidelines for the treatment and prevention of heart failure.(1)

Clinical trials, however, are performed in carefully selected subjects and their results are not always applicable to the general population. Large-scale registries or surveys, on the other hand, capture data from a much more heterogeneous population and are closer to everyday clinical practice (although the applicability of the sample may be a concern).

Now, the European CRT Survey, whose follow-up results are published today in the European Journal of Heart Failure, suggests that CRT does indeed reduce rates of death and re-hospitalisation among heart failure patients.(2) Indeed, at one-year follow-up most patients who had received a CRT device considered their symptoms were better than their pre-implant assessment.(3)

The survey - a joint initiative of the Heart Failure Association and European Heart Rhythm Association of the European Society of Cardiology (ESC) - gathered information on more than 2000 patients at 141 centres in 13 European countries. Its aim was to assess the effect of CRT on symptom severity, cardiovascular re-hospitalisation, and survival. The study population included subjects poorly represented in clinical trials but commonly admitted as heart failure patients - including the very elderly, those with atrial fibrillation, and those previously treated with a pacemaker or other cardiac device.

Analysis of the survey data showed that at, one year (average) follow-up, 81% reported a self-assessed improvement in their symptoms (with 16% no change and 4% a deterioration).

The survey also found that almost 25% of the subjects had died or been re-hospitalised within the 12-month follow-up period. This poor outcome (whose rate is consistent with that found in clinical trials - was directly associated with the diagnostic severity of the heart failure, the pre-existence of atrial fibrillation (or other heart disease), and the type of resynchronisation cardiac device implanted. Patients implanted with a pacing device only (CRT-P) had higher rates of mortality than those whose device had an additional defibrillator (CRT-D).

First author Dr Nigussie Bogale from Stavanger University Hospital in Norway said: "This is the largest study reporting a difference in outcome between CRT-D and CRT-P. Most patients with an indication for CRT have also an indication for a defibrillator. So unless they have contraindicating co-morbidities, it is now our belief that these patients should be considered for CRT-D implantation."

The use of advanced CRT devices has gained increasing acceptance in recent years and they are now being implanted on a large scale as an adjunct to conventional drug treatment. Indeed, some reports have described the two types of devices (CRT-P and CRT-D) as a revolution in heart failure. One important study cited in the most recent guidelines on heart failure suggested implantation of an ICD was associated with a 23% reduction in all-cause mortality.(4)

One study reporting in 2009 found that throughout 15 European countries the number of CRT implantations increased substantially, from 46/million in 2004 to 99/million in 2008, an increase of 115%. This was mainly explained by an increase in use of CRT-D devices. One study cited by many recent guidelines (MADIT-CRT) found that CRT-D decreased the risk of heart-failure events even in relatively asymptomatic patients (with a 34% reduction in the risk of all-cause mortality or heart failure).(5) This European CRT Survey now suggests that benefits of this nature - in both symptoms and survival - can be replicated in routine everyday practice.

However, despite the benefits and the recommendations, other studies show there is still a wide gap between those who meet the criteria for CRT and those who actually have a device implanted.
'/>"/>

Contact: ESC Press Office
press@escardio.org
33-049-294-8627
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. Publicly releasing inspection data on meat processing facilities could have substantial benefits
2. Does Psoriasis Thwart the Benefits of Good Cholesterol?
3. Kessler Foundation reports benefits of behavioral technique for cognitive rehabilitation in MS
4. Cooking Class Benefits Kids in Many Ways
5. Quality of life benefits of transcatheter aortic valve replacement differ by access site
6. Benefits of nut consumption for people with abdominal obesity, high blood sugar, high blood pressure
7. Increased use of bikes for commuting offers economic, health benefits
8. Glaucoma Experts Eye Benefits of Exercise
9. Religious, spiritual support benefits men and women facing chronic illness, MU study finds
10. USDA research demonstrates new breeds of broccoli remain packed with health benefits
11. BMC pediatricians find increase in SNAP benefits associated with healthier children
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/29/2016)... ... , ... Coast Dental Fort Stewart is celebrating its grand opening with an ... Furniture Mall at 112 Vilseck Road in Fort Stewart. There will be refreshments, giveaways, ... have the opportunity to meet general dentists Thomas Richards, DDS, and Josh Faulk, DMD, ...
(Date:4/29/2016)... ... ... Spine Team Texas, a comprehensive spine physician group specializing in the treatment of ... invited to be a featured speaker at the Texas Society of the American College ... , Dr. R. Scott McPherson, a physical medicine and rehabilitation specialist, will speak ...
(Date:4/29/2016)... ... April 29, 2016 , ... Mobility Designed is redefining mobility ... the armpits, the M+D Crutch evenly distributes body weight from the elbow to the ... when using the crutches than with other crutches. , Co-founders Max and Liliana Younger ...
(Date:4/29/2016)... ... April 29, 2016 , ... The ... (CCA), is pleased to announce the launch of the GFCP Scoop ... and more. The purpose of the GFCP Scoop site is to ...
(Date:4/29/2016)... ... 29, 2016 , ... Dr. Robert Mondavi, one of the dentists in ... is a fast-growing field as more patients are discovering the many different ways they ... the options currently available to them and which ones might work for their smiles. ...
Breaking Medicine News(10 mins):
(Date:4/29/2016)... , April 29, 2016 ... Review, H1 2016" market research report that provides ... with comparative analysis at various stages, therapeutics assessment ... of administration (RoA) and molecule type, along with ... It also reviews key players involved in the ...
(Date:4/29/2016)... , April 29, 2016 ... life science laboratory due to the growing demands for ... advance technology, contemporary automated systems are already adept of ... by slow, tedious and manual labor. Instrumentation continues to ... not even conceivable just a few years ago. Originally ...
(Date:4/28/2016)... April 28, 2016  Marking its one year ... and ovarian cancer risk test, Color Genomics ... genes that highly impact the most common hereditary ... the Color Test analyzes hereditary cancer risks for ... uterine cancers. The Color Test is physician ordered ...
Breaking Medicine Technology: