CRT in Heart Failure: Is the Defibrillator Needed? CRT in Heart Failure: Is the Defibrillator Needed?
Questions still remain as to the additive benefit of the defibrillator as an adjunct to cardiac resynchronization therapy.Europace
Impulse Dynamics, based in Mt. Laurel, New Jersey, has developed the Optimizer system, a device designed to improve myocardial contractility in patients with heart failure. The system is intended to improve the quality of life of heart failure patien...
Condition: Compare Two Programming Modalities for CRT Devices in Heart Failure Patients With an Indication for Cardiac Resynchronization Therapy Interventions: Device: conventional CRT; Device: MPP CRT Sponsor: CMC Ambroise Paré Withdrawn
Cardiac resynchronization therapy (CRT) has been associated to left ventricle (LV) remodelling, reduction of functional mitral regurgitation (FMR) and clinical improvement in patients with heart failure and reduced ejection fraction (HFrEF). The prevalence of significant FMR in patients with LV dyssynchrony that are candidate to CRT is up to 40%. Current approach in patients with FMR undergoing CRT consists of re-evaluation of the amount of FMR following a waiting period of at least 3 months after the implant.
Conclusions: CRT-D has higher greater cost-effectiveness across more subgroups in the indicated patient populations against as compared to OPT, ICD and CRT-P, from a US payer perspective. PMID: 32207659 [PubMed - as supplied by publisher]
Condition: Heart Failure Interventions: Procedure: Temporary pacing Study; Radiation: Thoracic CT; Diagnostic Test: Acute hemodynamic study; Diagnostic Test: Non-invasive body surface mapping; Diagnostic Test: Invasive catheter-based mapping Sponsors: Guy's and St Thomas' NHS Foundation Trust; King's College London Recruiting
ConclusionsTherapy with CRT-D compared to CRT-P resulted in an additional gain of QALYs, but was more expensive. In addition, the ICER was subject to uncertainty, especially due to the uncertainty in the survival benefit. A randomised controlled trial and subgroup analyses would be desirable to further inform decision making.