[Efficacy of biventricular pacemakers for heart failure]

Rigau Comas D, Sola Arnau I, Alonso Coello P, Martinez Pecino F
Record ID 32010000803
Authors' recommendations: Efficacy of cardiac resynchronization therapy in reducing mortality of patients with heart failure.The cardiac resynchronization therapy (CRT) in addition to traditional medical treatment reduces mortality for any cause in patients with symptomatic heart failure. The benefit is made extensive to those patients in functional class of N w York Heart Association, from NYHA II to IV and it is made evident at the three first months of treatment (High quality). The benefit is due, above all, to reduction in mortality due to progression of heart failure (High quality). The association of CRT with an implantable defibrillator does not alter the benefit (High quality). There is controversy around sudden deaths given that the scientific studies available report effects that are opposite to this variable (High quality).• Efficacy of cardiac resynchronization therapy in reducing the risk to be hospitalised due to progression of heart failure.CRT reduces the risk to be hospitalised due to progression of heart failure, conveying a higher benefit to those patients in functional class NYHA III / IV (Moderate quality).Efficacy of cardiac resynchronization therapy in monitoring clinical parameters.For clinical parameters assessing the capacity of effort of patients with heart failure, CRT is associated with an increase in the distance covered at six minutes (Moderate quality) and with a growth in the peak of oxygen uptake (Moderate quality). At three months, CRT improves the quality of life of patients with heart failure when added to traditional medical treatment. The benefit is higher in patients with CRT but without implantable defibrillator (High quality). CRT offers benefit which complements the traditional medical treatment and reduces the patients with heart failure’s symptoms (High quality) The evidence available and the magnitude of the benefit are not sufficient to confirm a possible clinical relevance of the outcomes.Efficacy of cardiac resynchronization therapy in reducing the risk to be hospitalised in patients with heart failure.CRT increases ejection fraction of left ventricle (High quality) and improves other echocardiographic parameters such as the telesystolic volume rate of left ventricle or delay of intraventricular conduction (moderate Quality). CRT reduces the duration of QRS interval (Moderate quality)Safety and risks of cardiac resynchronization therapy.CRT is a safe and well tolerated treatment. Mortality rate after implantation and up to discharge from hospital is low (lower than 1%) despite dealing with patients with low surgical risk. After discharge from hospital, the risk of infection is also relatively low (approx. 1%). One in 10 biventricular peacemakers cannot be implanted successfully (High quality). Most of severe complications arise from the introduction of the cable in the left ventricle and include, among others: anomalous position of the cable, perforation of coronary core, cardiac perforation (high quality).
Project Status: Completed
Year Published: 2008
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Cardiac Pacing, Artificial
  • Pacemaker, Artificial
Organisation Name: Andalusian Health Technology Assessment Area
Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309
Contact Name: aetsa.csalud@juntadeandalucia.es
Contact Email: aetsa.csalud@juntadeandalucia.es
Copyright: Andalusian Agency for Health Technology Assessment (AETSA)
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