Heart failure patients with an electrical problem that requires a single-lead pacemaker do better when both ventricles are paced, a randomized trial found.
Patients who underwent biventricular pacing had a 26% reduction in the combined endpoint of mortality, heart failure-related urgent care, and worsening heart function, according to Anne Curtis, MD, of the University of Buffalo School of Medicine in N.Y., and colleagues.
These patients with both a right and left ventricular pacing lead also had a 27% relative risk reduction in the composite endpoint of heart failure urgent care and all-cause mortality, Curtis reported here at the annual meeting of the American Heart Association.
Current guideline recommendations for adding cardiac resynchronization therapy (CRT) to those indicated for a pacemaker are "relatively weak, with level of evidence C," said study discussant Gerasimos Filippatos, MD, of the University of Athens in Greece. He and other experts on the subject indicated that this study would positively influence the guideline writing committees.
The hearts of patients with atrioventricular (AV) block have difficulty sending electrical signals to the ventricles, causing them to beat slowly or even not at all.
They are typically helped with the implantation of a standard pacemaker that normalizes the heart's beating by placing a lead in the right atrium and another in the right ventricle. But Curtis said this often leads to dyssynchrony between the left and right ventricles.
10/11/2012 : By Chris Kaiser / Med Page Today.
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