Procedure

Cardiac Resynchronization Therapy

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Cardiac Resynchronization Therapy, Cardiac Resynchronization Implantable Device

  • See Also
  1. Implantable Defibrillator
  2. Pacemaker
  3. Left Ventricular Assist Device (LVAD)
  • Indications
  • ACA/AHA and ESC/EHRA
  1. Ejection Fraction <30-35%
  2. NYHA Class 2-4 Heart Failure despite stable optimal medical therapy
  3. QRS Duration > 120 msec
    1. CRT did not show mortality or hospitalization benefit for QRS Duration 120-150 msec in meta-analysis
    2. Sipahi (2011) Arch Intern Med 171(16): 1454-62 [PubMed]
  • Contraindications
  1. Cardiogenic Shock
  2. Symptomatic Hypotension while in stable baseline rhythm
  3. Coronary revascularization (CABG or PTCA) within last 3 months
  4. Acute Myocardial Infarction within 40 days
  5. Clinical findings necessitating coronary revascularization
  6. Irreversible brain damage from cerebral disease
  7. Life Expectancy <1 year from other comorbidities
  • References
  1. McAlister (2007) JAMA 297(22):2502-14 [PubMed]
  2. Tang (2010) N Engl J Med 363(25): 2385-95 [PubMed]