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:1/23/2017)... (PRWEB) , ... January 23, 2017 , ... ... the premiere organization in North America for the scientific development, healthcare training and ... Annual Scientific Session, and its 2017 AAT Member Certification Qualification Courses for Technicians, ...
(Date:1/23/2017)... ... , ... "ProRandom is a set of camera tools that allow video editors to integrate up ... X," said Christina Austin - CEO of Pixel Film Studios. , With ProRandom, video ... footage. ProRandom works by using a virtual camera to create the illusion of a ...
(Date:1/23/2017)... ... 2017 , ... “Crossing the Bar”: a moving and eloquent drama depicting ... the Bar” is the creation of published author, Charlotte Hotte, a North Carolina native, ... the inspiration of the book to her sister, Denise, wishes to acknowledge her savior, ...
(Date:1/22/2017)... ... January 22, 2017 , ... Phytocéane invites clients to ... the rest of the world with ZANZIBAR MILKY CREAM. Inspired by the beauty of ... like Virgin Coconut Oil and moisturizing vegetal coral to create this gentle, velvety body ...
(Date:1/21/2017)... ... 21, 2017 , ... Salveo for life, a company that distributes an effervescent ... United States as part of its presence to expand its market reach. , Using ... the productions of nasty toxins as a result of drinking alcohol, eliminating those toxins ...
Breaking Medicine News(10 mins):
(Date:1/23/2017)... , Jan. 23, 2017  Delcath Systems, Inc. (NASDAQ: ... on the treatment of primary and metastatic liver cancers, ... MSN, CRNP, President and Chief Executive Officer of Delcath ... Noble Capital Markets, Thirteenth Annual Investor Conference at the ... Raton, Florida , on Tuesday, January 31, 2017 ...
(Date:1/23/2017)... Research and Markets has announced the addition of the ... to 2025" report to their offering. ... Report Highlights: The report provides ... investment opportunities Market forecasts till 2025, using estimated market ... the business segments, Regions and Countries Key developments and ...
(Date:1/23/2017)... DIEGO , Jan. 23, 2017  Using ... patients at high risk for acute kidney injury ... recommended by globally-recognized care guidelines significantly ... to severe AKI more than 33 percent, according ... in the journal Intensive Care Medicine. ...
Breaking Medicine Technology: