Resynchronization therapy is an important advance in the management of congestive heart failure: view of an antagonist.
The antagonist portion of the debate acknowledges that cardiac resynchronization therapy (CRT) is an important advance in the management of congestive heart failure, but the eligible treatment population currently is small relative to the whole. The impact of CRT on mortality without an implantable cardioverter defibrillator (ICD) probably is not significant, although a beneficial effect on morbidity associated with heart failure has clearly been achieved. The costs of CRT are not negligible. The morbidity and mortality of the procedure to implant these devices must be considered in future trial design.
Jessup
Mariell
M
Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. jessupm@uphs.upenn.edu
D002304:Cardiac Pacing, Artificial / Q000191:economics* / Q000379:methods* / Q000401:mortality / Q000639:trends; D018849:Controlled Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine / Q000379:methods; D006333:Heart Failure / Q000191:economics* / Q000628:therapy*; D006801:Humans; D010138:Pacemaker, Artificial / Q000191:economics*; D010346:Patient Care Management / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D016896:Treatment Outcome; D014481:United States