Cardiac resynchronisation therapy: when the drugs don’t work.

R A Bleasdale¹, M P Frenneaux²

¹ Department of Cardiology, Royal Glamorgan Hospital, Llantrisant, UK
² Department of Cardiovascular Medicine, University of Birmingham, Birmingham, UK

Correspondence to:
Correspondence to:
Dr R A Bleasdale
Department of Cardiology, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, CF72 8XR; bleasdalera@aol.com

Abbreviations: AV, atrioventricular; CRT, cardiac resynchronisation therapy; NYHA, New York Heart Association

Keywords: cardiac resynchronisation therapy; heart failure

The first 150 words of the full text of this article appear below.

Heart failure effects 1–2% of the population¹ and accounts for approximately 5% of all medical admissions²; despite the undoubted improvements in treatment over the past two decades, the outcome remains poor. One third of those patients admitted with decompensated heart failure die within one year of their first hospitalisation³ and up to 50% will be readmitted within the first six months after the initial hospitalisation.⁴ There appears little scope for further advances aimed at blocking neurohumoral maladaptive mechanisms, and other strategies, including cytokine blockade, have been disappointing. While cellular transplantation holds out considerable promise in the longer term, medically refractory heart failure remains a huge (and growing) clinical problem. Over the past decade an emerging body of evidence has suggested that biventricular and/or left ventricular pacing may provide effective palliation in some of these patients.

Initial attention regarding the potential use of pacing therapy in heart failure focused on . . . [Full text of this article]

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