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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

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

Comparison of CRT and CRT-D in heart failure: systematic review of controlled trials

Meng Jiang1, Ben He, Qi Zhang

  • 1Department of Cardiology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200001, China.

International Journal of Cardiology
|January 26, 2011
PubMed

Insights

Cardiac resynchronisation-cardioverter defibrillator therapy (CRT-D) significantly reduced all-cause death compared to cardiac resynchronisation therapy (CRT) in patients with left ventricular impairment. The benefit of CRT-D was more pronounced after one year of follow-up.

Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Trials

Background:

  • Limited comparative studies exist for cardiac resynchronisation therapy (CRT) versus CRT with cardioverter defibrillator (CRT-D) in patients with left ventricular (LV) impairment.
  • Heart failure management in LV impairment requires effective therapeutic strategies.

Purpose of the Study:

  • To systematically analyze and compare the therapeutic effects of CRT and CRT-D in patients suffering from LV impairment and heart failure.
  • To assess the impact of CRT-D on all-cause mortality in this patient population.

Main Methods:

  • A systematic literature search was conducted on the Medline database from 1970 to September 2010.
  • Seven studies involving 3404 patients were included in the analysis.
  • The primary outcome measure was the all-cause death rate.

Main Results:

  • CRT-D demonstrated an 8.42% reduction in all-cause death compared to CRT (OR 0.52, P=0.001).
  • This survival benefit was significant after one year of follow-up (OR 0.56, P=0.0004), but not within the first year (P=0.11).
  • Secondary endpoints, including sudden cardiac death and heart failure mortality, also favored CRT-D.

Conclusions:

  • CRT-D shows superiority over CRT in reducing all-cause and cardiac death rates after one year in patients with LV impairment.
  • Further validation through larger, randomized, prospective trials with extended follow-up is recommended to confirm these findings.
Abstract

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