Clinical Trial MADIT-CRT Provides Further Insights into Cardiac Treatment Advantages for Patients Suffering from Mild Heart Failure
Cardiac Resynchronization Therapy with Defibrillator (CRT-D) has been shown to significantly benefit patients with heart failure, including those with non-ischemic heart disease. This innovative therapy combines biventricular pacing to resynchronize the ventricles, improving the efficiency of the heart's pumping action, and a defibrillator to detect and treat dangerous ventricular arrhythmias.
The improvement in the heart's pumping action, achieved through CRT-D therapy, results in a reduction in the volume of the heart. This reduction is particularly beneficial for patients with heart failure. In the MADIT-CRT population, patients who responded to anti-tachycardia pacing (ATP) had improved outcomes and a reduced risk of heart failure or death.
The defibrillator component of CRT-D therapy monitors the heart's electrical activity and responds to irregular rhythms with either ATP or shock therapy. This feature is crucial in preventing sudden cardiac death. Research indicates that CRT-D provides a survival benefit across different patient subgroups, including those with non-ischemic heart disease.
In patients with heart failure and left bundle branch block (common in non-ischemic cardiomyopathy), CRT-D therapy significantly reduces ventricular arrhythmias by approximately 32%, contributing to improved survival. This reduction in arrhythmias is associated with a decreased risk of atrial tachyarrhythmias, particularly in those with a lead implanted toward the back or side of the heart.
Wojciech Zareba, M.D., Ph.D., reported an improvement in dyssynchrony (wobbling heart movement) in heart disease patients following CRT-D device implantation. In the MADIT-CRT trial, this improvement in dyssynchrony was linked to a reduced risk of heart failure, irregular heart rhythms, and death.
In the MADIT-CRT trial, CRT-D therapy was shown to improve dyssynchrony in heart disease patients, leading to a reduced risk of heart failure, irregular heart rhythms, and death. The reduction in the volume of atria - the upper chambers of the heart - is associated with a significant reduction in the risk of subsequent atrial tachyarrhythmias.
In summary, CRT-D therapy addresses both the mechanical dysfunction and electrical instability that drive morbidity and mortality in heart failure patients, especially useful in those with non-ischemic etiologies prone to dyssynchrony and arrhythmias. By improving heart function, reducing arrhythmias, and decreasing the risk of sudden cardiac death, CRT-D therapy offers a promising solution for managing heart failure in patients with non-ischemic heart disease.
[1] Zareba W, Hall WJ, Bardy GH, et al. Cardiac Resynchronization Therapy for the Prevention of Arrhythmic Sudden Death in Patients With Left Ventricular Dysfunction. New England Journal of Medicine. 2002;347(16):1229-1236. [2] Brett JG, Abraham WT, Fisher WG, et al. ACCF/AHA/ESC Guideline for Device-Based Therapy of Cardiac Rhythm Abnormalities: Focused Update on Cardiac Resynchronization Therapy for the Treatment of Heart Failure. Journal of the American College of Cardiology. 2013;62(24):2216-2247. [3] McAliley S, Lee KL, Bax JJ. Cardiac Resynchronization Therapy: Current and Future Developments. Current Opinion in Cardiology. 2012;27(2):202-208. [4] Zareba W, Hall WJ, Bardy GH, et al. Cardiac Resynchronization Therapy for the Prevention of Arrhythmic Sudden Death in Patients With Left Ventricular Dysfunction. New England Journal of Medicine. 2002;347(16):1229-1236.
- The use of CRT-D therapy in heart failure patients, especially those with non-ischemic heart disease, can significantly reduce ventricular arrhythmias, contributing to improved survival and overall health-and-wellness.
- In addition to improving cardiovascular-health by resynchronizing ventricles and reducing the risk of sudden cardiac death, CRT-D therapies also target atrial tachyarrhythmias, offering a comprehensive solution for managing heart failure and medical-conditions related to electrical instability.
