PMID- 19004666
OWN - NLM
STAT- MEDLINE
DCOM- 20090311
LR  - 20110608
IS  - 1388-9842 (Print)
IS  - 1388-9842 (Linking)
VI  - 10
IP  - 12
DP  - 2008 Dec
TI  - Successful treatment of heart failure with devices requires collaboration.
PG  - 1229-35
LID - 10.1016/j.ejheart.2008.09.015 [doi]
AB  - Implanted biventricular pacemakers (cardiac resynchronisation therapy, CRT) with 
      or without implantable cardioverter defibrillators (ICD) improve survival and 
      morbidity in some patients with chronic heart failure (CHF) who are optimally 
      treated with pharmacologic agents according to current guidelines. 
      Correspondingly, ICDs improve survival. However, there is only limited evidence 
      for device treatment in certain patient subgroups, such as the impact of ICD on 
      outcomes in patients with reduced ejection fraction in New York Heart Association 
      (NYHA) Class I or IV heart failure. Similarly, limited evidence exists for CRT in 
      patients with only modest QRS prolongation or only modestly reduced ejection 
      fraction. Despite evidence for a beneficial effect of device therapy in CHF, only 
      a minority of eligible patients are currently offered these options. Multiple 
      reasons contribute to the underuse of these potentially life-saving therapies. A 
      lack of adherence to guidelines by health care professionals is an important 
      barrier. Clearly, efforts should be made to improve the standard of care and to 
      familiarise all physicians involved in managing CHF patients with the indications 
      and potential efficacy of these devices. Increased collaboration between 
      structured heart failure care and pacemaker clinics as well as between 
      electrophysiologists, heart failure clinicians, and primary care physicians is 
      required. Such team collaborations should lead to improved care with reduced 
      mortality and morbidity and increased cost effectiveness. Treatment strategy 
      should be based on a structured approach tailored to local practice and national 
      priorities.
FAU - Swedberg, Karl
AU  - Swedberg K
AD  - Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, 
      University of Gothenburg, Goteborg, Sweden. karl.swedberg@gu.se
FAU - Cleland, John
AU  - Cleland J
FAU - Cowie, Martin R
AU  - Cowie MR
FAU - Nieminen, Markku
AU  - Nieminen M
FAU - Priori, Silvia G
AU  - Priori SG
FAU - Tavazzi, Luigi
AU  - Tavazzi L
FAU - van Veldhuisen, Dirk J
AU  - van Veldhuisen DJ
FAU - Alonso-Pulpon, Luis
AU  - Alonso-Pulpon L
FAU - Camm, John
AU  - Camm J
FAU - Dickstein, Kenneth
AU  - Dickstein K
FAU - Drexler, Helmut
AU  - Drexler H
FAU - Filippatos, Gerasimos
AU  - Filippatos G
FAU - Linde, Cecilia
AU  - Linde C
FAU - Lopez-Sendon, Jose
AU  - Lopez-Sendon J
FAU - Santini, Massimo
AU  - Santini M
FAU - Zannad, Faiez
AU  - Zannad F
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20081112
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
MH  - *Cardiac Pacing, Artificial
MH  - Chronic Disease
MH  - *Cooperative Behavior
MH  - Heart Failure/mortality/physiopathology/*therapy
MH  - Humans
MH  - *Pacemaker, Artificial
MH  - Stroke Volume
MH  - Time Factors
MH  - Ventricular Function, Left
RF  - 29
EDAT- 2008/11/14 09:00
MHDA- 2009/03/12 09:00
CRDT- 2008/11/14 09:00
PHST- 2008/08/11 00:00 [received]
PHST- 2008/09/22 00:00 [accepted]
PHST- 2008/11/14 09:00 [pubmed]
PHST- 2009/03/12 09:00 [medline]
PHST- 2008/11/14 09:00 [entrez]
AID - S1388-9842(08)00458-3 [pii]
AID - 10.1016/j.ejheart.2008.09.015 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2008 Dec;10(12):1229-35. doi: 10.1016/j.ejheart.2008.09.015. 
      Epub 2008 Nov 12.