PMID- 22521934
OWN - NLM
STAT- MEDLINE
DCOM- 20121128
LR  - 20161222
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Linking)
VI  - 9
IP  - 8 Suppl
DP  - 2012 Aug
TI  - Cardiac resynchronization therapy (CRT): clinical trials, guidelines, and target 
      populations.
PG  - S3-S13
LID - 10.1016/j.hrthm.2012.04.026 [doi]
AB  - Over the last 10 years, several large, well-designed clinical trials have firmly 
      established the role of cardiac resynchronization therapy (CRT) as a recommended 
      treatment strategy for moderate-to-severe heart failure (HF). A review of the 
      relevant results from the MUSTIC, MIRACLE, CONAK-CD, and MIRACLE ICD trials 
      reveals that in patients with New York Heart Association (NYHA) class III-IV HF, 
      CRT produces consistent improvements in quality of life, functional status, and 
      exercise capacity while also providing strong evidence for reverse remodeling and 
      diminished functional mitral regurgitation, resulting in reductions in both HF 
      hospitalizations and all-cause morbidity and mortality. In patients with earlier 
      NYHA class I-II HF, the benefit of CRT has been more controversial. The principal 
      ongoing challenges addressed in this article include the substantial 30% of 
      patients who receive a CRT device but fail to respond, the wide variations in how 
      to define "response" vs "nonresponse," and how to identify patients who will 
      benefit from CRT, especially narrow QRS (<120 ms), those with right bundle branch 
      block, and those with mild-to-moderate (NYHA class I-II) HF. An important result 
      of this uncertainty is the lack of a good sense of the optimal rate of CRT 
      implantation, making consideration of the data reviewed in this article crucial 
      for identifying important gaps of knowledge and mechanisms of action that need to 
      be studied in the near future.
CI  - Copyright (c) 2012 Heart Rhythm Society. All rights reserved.
FAU - Linde, Cecilia
AU  - Linde C
AD  - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. 
      Cecilia.Linde@ki.se
FAU - Ellenbogen, Kenneth
AU  - Ellenbogen K
FAU - McAlister, Finlay A
AU  - McAlister FA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20120420
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
MH  - Bundle-Branch Block/pathology
MH  - Cardiac Resynchronization Therapy/*methods
MH  - *Clinical Trials as Topic
MH  - Heart Failure/pathology/*therapy
MH  - Heart Ventricles/pathology
MH  - Humans
MH  - *Practice Guidelines as Topic
MH  - Severity of Illness Index
MH  - Ventricular Remodeling
EDAT- 2012/04/24 06:00
MHDA- 2012/12/10 06:00
CRDT- 2012/04/24 06:00
PHST- 2012/01/13 00:00 [received]
PHST- 2012/04/24 06:00 [entrez]
PHST- 2012/04/24 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - S1547-5271(12)00414-6 [pii]
AID - 10.1016/j.hrthm.2012.04.026 [doi]
PST - ppublish
SO  - Heart Rhythm. 2012 Aug;9(8 Suppl):S3-S13. doi: 10.1016/j.hrthm.2012.04.026. Epub 
      2012 Apr 20.