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Researchers pinpoint patients who receive greatest benefit from heart failure treatment
Date:3/1/2011

Mild heart failure patients with a particular condition that results in disorganized electrical activity throughout the heart benefit substantially from cardiac resynchronization therapy with defibrillator (CRTD), according to a study published in the American Heart Association journal Circulation.

In patients with the condition, known as left bundle branch block or LBBB, CRT-D therapy reduced heart failure progression and the risk of ventricular tachyarrhythmias, fast and potentially life-threatening heart rhythms. Heart failure patients without LBBB did not receive any benefit from the therapy.

The analysis, based on the major study which tested the device the MADIT-CRT trial led the FDA to extend the approval of the CRT-D in September 2010 to patients with mild heart failure and LBBB to prevent progression to advanced heart failure. The device, developed by Boston Scientific, was originally approved to treat patients with severe heart failure.

"This study allowed us to identify the specific set of patients that receive the greatest benefit from this device," said Wojciech Zareba, M.D., Ph.D., lead study author and director of the Heart Research Follow-up Program at the University of Rochester Medical Center. "Our analysis highlights the fact that this therapy is not equally effective in all mild heart failure patients and was the basis of the FDA's approval of the therapy only in patients with left bundle branch block."

Zareba's team found that patients with LBBB who received CRT-D therapy had a significant 53 percent reduction in the risk of a heart failure event, such as being hospitalized with heart failure symptoms, or death, compared to LBBB patients who only received an implantable cardioverter defibrillator (ICD). The risk of ventricular tachyarrhythmias was also considerably less in LBBB patients with CRT-D.

CRT-D therapy combines an ICD, which senses dangerous abnormal heart rhythms and atte
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Contact: Emily Boynton
emily_boynton@urmc.rochester.edu
585-273-1757
University of Rochester Medical Center
Source:Eurekalert

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