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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Cardiac resynchronization therapy utilization for heart failure: findings from IMPROVE HF
Anne B Curtis1, Clyde W Yancy, Nancy M Albert
1University of South Florida College of Medicine, Tampa, FL 33612, USA. acurtis@health.usf.edu
American Heart Journal
|December 5, 2009
Summary
Cardiac resynchronization therapy (CRT) is underutilized in eligible heart failure patients, with significant practice variations. Age, insurance, QRS duration, and location impact CRT device utilization.
Area of Science:
- Cardiology
- Heart Failure Management
- Medical Device Utilization
Background:
- Cardiac resynchronization therapy (CRT) is effective for systolic heart failure (HF).
- CRT utilization rates and influencing factors in outpatient cardiology practices remain understudied.
Purpose of the Study:
- To investigate CRT treatment rates among eligible heart failure patients.
- To identify patient and practice characteristics associated with CRT utilization.
Main Methods:
- Prospective cohort study (IMPROVE HF) of 15,381 chronic HF patients in US outpatient cardiology practices.
- Baseline data collected via chart review (May 2005-June 2007).
- Multivariable analyses identified predictors of CRT use in 1,373 eligible patients.
Main Results:
- 38.8% of eligible patients received a CRT device; 84.1% were CRT-defibrillators.
- Wide practice variation in CRT use (11.1% to 53.4%).
- Higher CRT utilization associated with patient age, insurance, longer QRS duration, and practice location.
Conclusions:
- CRT is underutilized despite guideline recommendations.
- Significant variations in CRT use exist, linked to patient demographics and practice location.
- Practice-specific initiatives may be needed to improve CRT utilization.
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