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Submitted: 02 September 2007
HERDIN Record #: PCHRD090107020959

A meta-analysis on cardiac resynchronization therapy for the treatment of chronic heart failure.

Geraldine G. Garrido-Pon

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BackgroundÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Cardiac resynchronization therapy by means of biventricular pacing is a fairly new procedure that has recently been approved by the US-FDA.

Studies have shown that there was a high incidence of left bundle branch block (LBBB) or intraventricular conduction delay in congestive heart failure (CHF) resulting in interventricular dyssynchrony. This then leads to a prolonged delay between the onset of left ventricular and right ventricular conduction as well as a decrease in the duration of left vetricular diastole. By simultaneously pacing the left ventricle along with the right ventricle, a more synchronous ventricular contraction pattern could be achieved resulting in the reduction in QRS duration and thereby a reduction in QRS duration and thereby a reduction in intraventricular asynchrony.

Methods and ResultsÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ The objective of the study is to do a meta-analytic review of four (4) randomized controlled trials on cardiac resynchonization therapy for the management of chronic heart failure.

Included in this review were studies conducted in humans, randomized controlled trials on cardiac resynchronization therapy without ICD implantation in the management of congestive heart failure on patients in sinus rhythm.

At pooled analysis, cardiac resynchronization therapy appears to improve significantly the outcome of patients in chonic heart failure compared to patients given medical therapy alone in terms of the following variables: Mortality rate was significantly lower for patients on both medical therapy and CRT compared to those on medical therapy alone: In all variables, cardiac resynchronization therapy significantly improve both the clinical symptoms as well as the multiple measures of functional status of patients in chronic heart failure.

Conclusion ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Cardiac resynchronization therapy offers significant improvement in the quality of life and functional capacity of patients in advanced heart failure. In these subset of patients, It has effectively reduced the morbidity and mortality compared to those with optimal medical management only. (Author)

Publication Type
Journal
Publication Sub Type
Review Articles/Metaanalysis
Title
Philippine Heart Center Journal
Frequency
Quarterly
Publication Date
January-March 2006
Volume
12
Issue
1
Page(s)
39-40

Objectives

To do a meta-analytic review of four (4) randomized controlled trials on cardiac resynchronization therapy for the management of chronic heart failure.

LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)

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