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Resynchronization Can Slow Heart Failure Progression

Study finds patients with mildly symptomatic left ventricular dysfunction may benefit

FRIDAY, Oct. 2 (HealthDay News) -- Cardiac resynchronization therapy (CRT) improves clinical outcomes, as well as left ventricular function and size, in patients with asymptomatic or mildly symptomatic left ventricular dysfunction, according to a study published online Sept. 30 in the Journal of the American College of Cardiology.

Claude Daubert, M.D., of the Centre Hospitalier Universitaire in Rennes, France, and colleagues randomly assigned 262 patients with CRT pacemakers or defibrillators with left ventricular ejection fraction of no more than 40 percent and a QRS complex of at least 120 ms to active CRT or control treatment for 24 months.

The researchers found that significantly fewer patients who received active CRT had a worsened heart failure clinical composite response versus controls (19 versus 34 percent). The left ventricular end-systolic volume index also fell significantly more in patients receiving active CRT as compared to controls. In addition, active CRT significantly delayed the time to first heart failure hospital stay or death (hazard ratio, 0.38).

"Given the growing evidence for CRT as a means to delay heart failure progression, it is tempting to recommend it beyond present guidelines," Derek V. Exner, M.D., of the University of Calgary in Canada writes in an accompanying editorial. "However, it is premature to recommend CRT as a routine intervention to patients with asymptomatic left ventricular dysfunction or those with mildly symptomatic heart failure today."

The study was supported by the Medtronic. Several authors of the study and the author of the editorial reported financial and consulting relationships with medical device companies.

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