Cardiac resynchronisation therapy for chronic heart failure

• Published in: BMJ. British medical journal (International ed.) Vol. 338; no. 7702; pp. 1064 - 1069
• Main Authors: CUBBON, Richard M, WITTE, Klaus K. A
• Format: Journal Article
• Language: English
• Published: London British Medical Association 02-05-2009; BMJ Publishing Group
• Edition: International edition
• Subjects: Biological and medical sciences; Cardiology. Vascular system; General aspects; Heart; Heart failure; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Medical sciences; Mortality; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Therapy; Heart failure; Medicine; Instrumental stimulation; Chronic; Heart disease; Instrumentation therapy; Cardiovascular disease
• ISSN: 0959-8146

Chronic heart failure is common, affecting about 900,000 people in the UK and with a prevalence of about 6-10% in people aged over 65 years; despite modern drug treatment, it carries a high morbidity and a 10% annual mortality. A recent addition to therapeutic algorithms for chronic heart failure is cardiac resynchronization therapy. Cardiac resynchronization therapy is a well proved treatment for patients with heart failure who have left ventricular systolic dysfunction and conduction delay, and it can reduce symptoms and admission to hospital and improve quality of life and prognosis. Clear mortality benefits have moved it from a treatment for intractable symptoms to one that, alongside β blockers, angiotensin converting enzyme inhibitors, and aldosterone antagonists, is now a routine therapy for patients with current or previous severe chronic heart failure. Here, Cubbon and Witte review the evidence and indications for cardiac resynchronization therapy and discuss the clinical features that should alert general physicians and general practitioners to patients who may benefit from this therapy.