[Effect of CRT on morbidity and mortality].
Patients with chronic heart failure who show a left ventricular ejection fraction < or =35% and remain in NYHA class III or IV despite optimal pharmacologic treatment show less morbidity and mortality on cardiac resynchronization therapy (CRT) if the left ventricle shows asynchrony. Although only one study has shown a significant reduction of mortality about 4% less deaths per year in the first two years can be resumed. Procedure related mortality is less than 1%. By improving on average one NYHA class 10-20% less patients experience hospitalization due to heart failure in the first two years after implantation of a CRT device. Patients who are hospitalized despite CRT have on average a hospital stay below 5 days. At least 10% of patients are currently suffering surgical revisions due to infections, dislocations and high pacing thresholds of the left ventricular lead. If costs saved by less hospitalization can finance costs of CRT or even exceed the costs of CRT remains unknown.
Block
M
M
Stiftsklinik Augustinum, Wolkerweg 16, 81375 München, Germany. block@med.augustinum.de
Brömsen
J
J
D002304:Cardiac Pacing, Artificial / Q000379:methods / Q000706:statistics & numerical data*; D015984:Causality; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D015897:Comorbidity; D006333:Heart Failure / Q000401:mortality* / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D019990:Perioperative Care / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011379:Prognosis; D020127:Recovery of Function; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000401:mortality* / Q000517:prevention & control*