Cardiac resynchronization therapy in combination with implantable cardioverter-defibrillator.
Device therapy for heart failure has a spectacular development during the last 10 years. Patients with chronic heart failure might benefit from electrical therapy with a view to: (i) resynchronize the failing and dyssynchronized heart and improve its mechanical performance or (ii) prevent the risk of sudden death by automatic defibrillation. These two therapies can be applied together with a combined device, the biventricular implantable cardioverter-defibrillator (CRT-D). Today, the proportion of CRT-D devices among all CRT devices implanted around the world is more than 75% and more than 85% in the USA. This review article will try to answer some important questions for clinical practice: is the growing use of CRT-D devices supported by clinical evidence? Is the risk-benefit profile of CRT-D favourable in particular in mildly symptomatic patients?
Daubert
J Claude
JC
Department of Cardiology and Vascular Diseases, Hôpital Pontchaillou-CHU, Rennes, 35033 France. jean-claude.daubert@chu-rennes.fr
Leclercq
Christophe
C
Mabo
Philippe
P
D002304:Cardiac Pacing, Artificial / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D017147:Defibrillators, Implantable / Q000191:economics; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome