PMID- 15785177
OWN - NLM
STAT- MEDLINE
DCOM- 20050411
LR  - 20191109
IS  - 1541-9215 (Print)
IS  - 1541-9215 (Linking)
VI  - 1
IP  - 1
DP  - 2003 Winter
TI  - Cardiac resynchronization therapy for the management of chronic heart failure.
PG  - 55-61
AB  - While numerous pathophysiologic mechanisms may lead to the onset and progression 
      of chronic systolic heart failure, a variety of electrophysiologic abnormalities 
      seen in the setting of chronic left ventricular dysfunction may also contribute 
      to the natural history of the disease. Atrial, atrial-ventricular, and inter- and 
      intraventricular conduction disturbances may place the failing ventricle at a 
      further mechanical disadvantage, thus contributing to the functional impairment 
      and poor outcomes associated with chronic heart failure. In the early 1990s, 
      attempts at treating patients with end-stage systolic heart failure using 
      conventional pacing strategies met with equivocal results. However, this work did 
      provide further insight into the electromechanical consequences of advanced heart 
      failure and suggested that atrial-synchronized biventricular pacing, or cardiac 
      resynchronization therapy, might provide better and more consistent symptomatic 
      and hemodynamic improvement. Several landmark clinical trials have evaluated the 
      safety and efficacy of cardiac resynchronization therapy in New York Heart 
      Association (NYHA) class III and IV heart failure. These studies have 
      consistently shown statistically significant improvements in quality of life, 
      NYHA functional class ranking, exercise tolerance, and left ventricular reverse 
      remodeling. Some studies have suggested reductions in morbidity and mortality. 
      This latter observation has been confirmed by a recent large-scale outcomes 
      study. Thus, cardiac resynchronization therapy should be routinely considered in 
      eligible NYHA class III and IV heart failure patients with ventricular 
      dyssynchrony.
FAU - Abraham, William T
AU  - Abraham WT
AD  - Department of Internal Medicine, Division of Cardiovascular Medicine, Davis Heart 
      and Lung Research Institute, Ohio State University, Columbus, OH, USA. 
      abraham-1@medctr.osu.edu
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PL  - England
TA  - Am Heart Hosp J
JT  - The American heart hospital journal
JID - 101156064
SB  - IM
MH  - Cardiac Pacing, Artificial/*methods
MH  - Cardiomyopathy, Dilated/therapy
MH  - Chronic Disease
MH  - Clinical Trials as Topic
MH  - Double-Blind Method
MH  - Electrocardiography
MH  - Heart Failure/mortality/physiopathology/*therapy
MH  - Humans
MH  - Multicenter Studies as Topic
MH  - *Pacemaker, Artificial
MH  - Patient Selection
MH  - Prospective Studies
MH  - Quality of Life
MH  - Randomized Controlled Trials as Topic
MH  - Safety
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/physiopathology/therapy
MH  - Ventricular Remodeling
RF  - 41
EDAT- 2005/03/24 09:00
MHDA- 2005/04/12 09:00
CRDT- 2005/03/24 09:00
PHST- 2005/03/24 09:00 [pubmed]
PHST- 2005/04/12 09:00 [medline]
PHST- 2005/03/24 09:00 [entrez]
AID - 10.1111/j.1541-9215.2003.02079.x [doi]
PST - ppublish
SO  - Am Heart Hosp J. 2003 Winter;1(1):55-61. doi: 10.1111/j.1541-9215.2003.02079.x.