PMID- 19379637
OWN - NLM
STAT- MEDLINE
DCOM- 20090724
LR  - 20211020
IS  - 1534-3170 (Electronic)
IS  - 1523-3782 (Linking)
VI  - 11
IP  - 3
DP  - 2009 May
TI  - Cardiac resynchronization therapy in NYHA class IV heart failure.
PG  - 175-83
AB  - Clinical practice guidelines recommend cardiac resynchronization therapy (CRT) 
      for ambulatory New York Heart Association (NYHA) class IV patients with a QRS 
      duration >or= 120 ms and a left ventricular ejection fraction <or= 35%. Only two 
      prospective, randomized trials have compared outcomes after CRT in NYHA class III 
      and IV patients. CRT improved mortality, exercise capacity, and quality of life 
      in class IV patients, but the 1-year mortality remained high. Patients in these 
      trials were in sinus rhythm at randomization and most patients had a left bundle 
      branch block. Less data are available for NYHA class IV patients with atrial 
      fibrillation, right bundle branch block, and previous ventricular pacing. No 
      prospective randomized data are available for the use of CRT as rescue therapy in 
      inotrope-dependent patients, but several case series have reported promising 
      results. It is likely that "rescue therapy" with CRT will be most beneficial when 
      patients improve enough with CRT to allow reinstitution of angiotensin-converting 
      enzyme inhibitors and beta blockers.
FAU - Khoo, Michelle
AU  - Khoo M
AD  - University of Colorado Health Sciences Center, 1635 Aurora Court, F749, Aurora, 
      CO 80045, USA.
FAU - Kelly, Patricia A
AU  - Kelly PA
FAU - Lindenfeld, JoAnn
AU  - Lindenfeld J
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Cardiol Rep
JT  - Current cardiology reports
JID - 100888969
SB  - IM
MH  - Bundle-Branch Block/diagnosis/mortality/therapy
MH  - Cardiac Pacing, Artificial/methods/*standards
MH  - Defibrillators, Implantable/*standards
MH  - Exercise Tolerance
MH  - Female
MH  - Heart Conduction System/physiopathology
MH  - Heart Failure/*classification/mortality/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Pacemaker, Artificial
MH  - *Practice Guidelines as Topic
MH  - Prognosis
MH  - Quality of Life
MH  - Randomized Controlled Trials as Topic
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Survival Analysis
MH  - Treatment Outcome
RF  - 42
EDAT- 2009/04/22 09:00
MHDA- 2009/07/25 09:00
CRDT- 2009/04/22 09:00
PHST- 2009/04/22 09:00 [entrez]
PHST- 2009/04/22 09:00 [pubmed]
PHST- 2009/07/25 09:00 [medline]
AID - 10.1007/s11886-009-0026-8 [doi]
PST - ppublish
SO  - Curr Cardiol Rep. 2009 May;11(3):175-83. doi: 10.1007/s11886-009-0026-8.