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Updated: Jun 23, 2026
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Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
Published on: April 8, 2013
Cardiac resynchronization therapy for patients with left ventricular systolic dysfunction: a systematic review
Finlay A McAlister1, Justin Ezekowitz, Nicola Hooton
1The University of Alberta Evidence-based Practice Center, Edmonton, Alberta, Canada. finlay.mcalister@ualberta.ca
JAMA
|June 15, 2007
Summary
Cardiac resynchronization therapy (CRT) significantly reduces morbidity and mortality in patients with left ventricular systolic dysfunction and heart failure symptoms. This therapy improves heart function, quality of life, and survival rates when combined with optimal pharmacotherapy.
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Management
Background:
- Left ventricular (LV) systolic dysfunction is a major cause of morbidity and mortality.
- Optimal pharmacotherapy does not fully address the needs of all patients.
- Cardiac resynchronization therapy (CRT) received FDA approval in 2001 for selected patients.
Purpose of the Study:
- To evaluate the efficacy, effectiveness, and safety of CRT in patients with LV systolic dysfunction.
- To summarize the current evidence base for CRT in this patient population.
Main Methods:
- Systematic review of electronic databases and hand searches until November 2006.
- Inclusion of 14 randomized trials for efficacy (4420 patients).
- Inclusion of 106 studies for effectiveness (9209 patients) and 89 studies for safety (9677 patients).
Main Results:
- Patients had LV systolic dysfunction (LVEF 21%-30%), prolonged QRS (155-209 ms), and NYHA class 3-4 symptoms.
- CRT improved LVEF (3.0%), quality of life (8.0 points), and functional status (59% improved >=1 NYHA class).
- CRT reduced hospitalizations (37%) and all-cause mortality (22%); implant success was 93.0%.
Conclusions:
- CRT is effective in reducing morbidity and mortality for patients with LV systolic dysfunction, prolonged QRS, and severe heart failure symptoms.
- CRT should be considered as an adjunct to optimal pharmacotherapy.
- The benefit of CRT combined with implantable cardioverter-defibrillators versus CRT alone requires further investigation.
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