Do we have sufficient evidence in 2009 to decide whether to implant biventricular pacemaker or cardioverter-defibrillator to cardiac resynchronization therapy patients?

Authors: M. Táborský;  P. Neužil
Authors‘ workplace: Kardiocentrum, Nemocnice Na Homolce, Praha
Published in: Kardiol Rev Int Med 2009, 11(1): 16-19


Do we have sufficient evidence in 2009 to decide whether to implant biventricular pacemaker or cardioverter-defibrillator to cardiac resynchronization therapy patients? Cardiac resynchronization therapy represents one of the standard non‑pharmacological treatment of severe heart failure in patiens with significant left ventricle dysfunction and ventricular dyssynchrony. The choise of device has to consider the potential benefit of the therapy – the comorbidities, the life expectancy but also the cost‑effectiveness and the potential complications related to the device. New devices provide information about the hemodynamical status of this heart failure patient population allowing early detection of heart failure decompensation – for example using home monitoring – avoiding recurrent hospitalisations from this reason. Based on analysis of recent clicinal studies, in 2009 we do not have enough data if for patients with CRT indication is the biventricular ICD better compared to the biventricular pacemaker. The only one exception are patients with end‑stage heart failure, NYHA IV class, where the implant of biventricular pacemaker is preferred.

cardiac resynchronization therapy – heart failure – ICD – pacemaker


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