title: On the underutilization of cardiac resynchronization therapy.
abstract: Cardiac resynchronization therapy (CRT) is an exciting therapy that can treat patients with systolic heart failure and left ventricular dysfunction who have a wide QRS complex. Indications for its use have been refined and expanded based on recent clinical data and guidelines, yet the rate of new CRT implants in the United States has not changed much over the past 8 years. Many patients receiving implantable cardioverter-defibrillators can benefit from, but are not receiving, appropriately-indicated CRT devices. We summarize data on CRT use, discuss reasons for probable underutilization, and provide recommendations for augmenting proper and effective use of this highly beneficial therapy.
authors.affiliation: United Heart and Vascular Clinic, St Paul, Minnesota. Electronic address: alan.bank@allina.com.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Bank
authors.affiliation: United Heart and Vascular Clinic, St Paul, Minnesota.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Gage
authors.affiliation: University of Iowa, Iowa City, Iowa.
authors.forename: Brian
authors.initials: B
authors.lastname: Olshansky
mesh_terms: D058406:Cardiac Resynchronization Therapy / Q000191:economics / Q000706:statistics & numerical data*; D002983:Clinical Competence; D003657:Decision Making; D017147:Defibrillators, Implantable / Q000191:economics / Q000706:statistics & numerical data*; D019983:Guideline Adherence; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012051:Reimbursement Mechanisms; D018487:Ventricular Dysfunction, Left / Q000628:therapy*
keywords: Cardiac resynchronization therapy; heart failure; implantable cardioverter defibrillator; utilization