Journal review. Trials on cardiac resynchronization therapy. Early trials Randomised controlled trials Specific issues NYHA I/II AF Narrow QRS Upgradation of pacemaker Echo assessment of dyssynchrony Role of CMR. Cazeau et al ,1994 54yr,NYHA IV,LBBB,QRS dur200 ms
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Trials on cardiac resynchronization therapy
McAlister et al,2004-meta-analysis of several CRT trials- HF hospitalizations were reduced by 32% and all-cause mortality by 25%
Primary Composite endpoint : all-cause mortality, HF hospitalizations, crossover due to worsening HF, NYHA class, and the patient global assessment assessed in double blind manner
MADIT-CRT and REVERSE enrolled a small proportion of asymptomatic patients, only 15% and 18%, respectively
MUSTIC AF first randomized trial demonstrating possible benefits of CRT in HF in pts with permanent AF
In patients with a conventional indication for pacing, NYHA III/IV symptoms, an LVEF of ≤35%, and a QRS width of ≥120 ms,CRT-P/CRT-D is indicated.
Internal flow fraction fraction (IFF) is defined as the total internal flow as a percentage of stroke volume