PMID- 19437393
OWN - NLM
STAT- MEDLINE
DCOM- 20090716
LR  - 20090513
IS  - 1898-018X (Electronic)
IS  - 1898-018X (Linking)
VI  - 16
IP  - 3
DP  - 2009
TI  - Cardiac resynchronization therapy in heart failure patients: an update.
PG  - 197-209
AB  - Heart failure continues to be a major public health problem with high morbidity 
      and mortality rates, despite the advances in medical treatment. Advanced heart 
      failure patients have severe persistent symptoms and a poor quality of life. 
      Cardiac resynchronization therapy (CRT), an invasive therapy which involves 
      synchronized pacing of both right and left ventricles, improves ventricular 
      conduction delay and left ventricular performance. Several clinical trials of CRT 
      in medically refractory heart failure patients with wide QRS (> 120 ms), left 
      ventricular ejection fraction <or=35% and New York Heart Association (NYHA) class 
      III and IV have shown improved quality of life, NYHA class, left ventricular 
      ejection fraction and reduced mortality. About 30% of heart failure patients who 
      receive CRT do not respond to treatment. Mechanical dyssynchrony may play a role 
      in identifying patients who may respond better to CRT treatment. However, recent 
      large scale clinical trials PROSPECT and RethinQ have challenged this concept. 
      The role of CRT in heart failure patients with narrow QRS (< 120 ms), NYHA class 
      I and II, atrioventricular nodal ablation in patients with atrial fibrillation 
      and triple site pacing are evolving. Our review discusses the current evidence, 
      indications, upcoming trials and future directions.
FAU - Jeevanantham, Vinodh
AU  - Jeevanantham V
AD  - General Internal Medicine, Wake Forest University, Winston-Salem, NC 27157, USA. 
      vjeevanantham@gmail.com
FAU - Daubert, James P
AU  - Daubert JP
FAU - Zareba, Wojciech
AU  - Zareba W
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Poland
TA  - Cardiol J
JT  - Cardiology journal
JID - 101392712
SB  - IM
MH  - *Cardiac Pacing, Artificial
MH  - Defibrillators, Implantable
MH  - Electric Countershock/instrumentation
MH  - Evidence-Based Medicine
MH  - Heart Failure/mortality/physiopathology/*therapy
MH  - Humans
MH  - *Pacemaker, Artificial
MH  - Patient Selection
MH  - Practice Guidelines as Topic
MH  - Quality of Life
MH  - Recovery of Function
MH  - Treatment Outcome
MH  - Ventricular Function, Left
RF  - 76
EDAT- 2009/05/14 09:00
MHDA- 2009/07/17 09:00
CRDT- 2009/05/14 09:00
PHST- 2009/05/14 09:00 [entrez]
PHST- 2009/05/14 09:00 [pubmed]
PHST- 2009/07/17 09:00 [medline]
PST - ppublish
SO  - Cardiol J. 2009;16(3):197-209.