PMID- 25405947
OWN - NLM
STAT- MEDLINE
DCOM- 20161114
LR  - 20161230
IS  - 1558-2035 (Electronic)
IS  - 1558-2027 (Linking)
VI  - 17
IP  - 4
DP  - 2016 Apr
TI  - BLOCK HF: how far does it extend indications for cardiac resynchronization 
      therapy?
PG  - 306-8
LID - 10.2459/JCM.0000000000000147 [doi]
AB  - The Biventricular versus Right Ventricular Pacing in Heart Failure Patients with 
      Atrioventricular Block (BLOCK HF) trial, published in April 2013 [Curtis AB, 
      Worley SJ, Adamson PB, et al; Biventricular versus Right Ventricular Pacing in 
      Heart Failure Patients with Atrioventricular Block (BLOCK HF) Trial 
      Investigators. Biventricular pacing for atrioventricular block and systolic 
      dysfunction. N Engl J Med 2013; 368:1585-1593], explored whether cardiac 
      resynchronization therapy (CRT) was superior to conventional pacing in patients 
      with conventional indications for pacing, left ventricular dysfunction and NYHA 
      (New York Heart Association) class I-III. The trial took 8 years and a source of 
      concern is selection bias, because participating centers had an average of two 
      patients enrolled per center, per year. Both the internal and external validity 
      of the trial merit some comments. BLOCK HF showed a relatively low treatment 
      effect of CRT as compared with other CRT trials. As a matter of fact, the 
      absolute risk reduction for death or hospitalization because of heart failure was 
      4.8%, in a relatively long follow-up, with a number needed to treat (NNT) of 21, 
      much higher than the NNT of other CRT trials. We estimate that at least one third 
      of patients in BLOCK HF could meet current indications for CRT. Moreover, the 
      study did not consider the additional risks and costs of CRT versus conventional 
      pacing, both having important implications for cost-effectiveness estimates. For 
      these and other reasons, uncertainties arise as to how far BLOCK HF extends 
      current recommendations for CRT and how much it should be implemented in daily 
      clinical practice.
FAU - Boriani, Giuseppe
AU  - Boriani G
AD  - aInstitute of Cardiology, Department of Experimental, Diagnostic and Specialty 
      Medicine, University of Bologna, S. Orsola-Malpighi University Hospital, Bologna, 
      Italy bCentre for Cardiovascular Sciences, Queen Elizabeth Hospital, University 
      of Birmingham, Birmingham, UK.
FAU - Ziacchi, Matteo
AU  - Ziacchi M
FAU - Diemberger, Igor
AU  - Diemberger I
FAU - Biffi, Mauro
AU  - Biffi M
FAU - Martignani, Cristian
AU  - Martignani C
FAU - Leyva, Francisco
AU  - Leyva F
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - J Cardiovasc Med (Hagerstown)
JT  - Journal of cardiovascular medicine (Hagerstown, Md.)
JID - 101259752
SB  - IM
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Heart Failure/complications/mortality/physiopathology/*therapy
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Multicenter Studies as Topic
MH  - Patient Selection
MH  - Randomized Controlled Trials as Topic/methods
MH  - Research Design
MH  - Selection Bias
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/etiology
EDAT- 2014/11/19 06:00
MHDA- 2016/11/15 06:00
CRDT- 2014/11/19 06:00
PHST- 2014/11/19 06:00 [entrez]
PHST- 2014/11/19 06:00 [pubmed]
PHST- 2016/11/15 06:00 [medline]
AID - 10.2459/JCM.0000000000000147 [doi]
PST - ppublish
SO  - J Cardiovasc Med (Hagerstown). 2016 Apr;17(4):306-8. doi: 
      10.2459/JCM.0000000000000147.