The MADIT -CRT study (Multicenter Automatic Defibrillator Implantation with Cardiac Resynchronization Therapy) had shown that early intervention with cardiac resynchronization therapy plus defibrillator in patients with electrical block pattern of complete left bundle branch was associated with a significant reduction of events in a mean follow-up of 2.4 years compared with the defibrillation therapy only.In this study the effect on long-term survival (mean 5.6 years) of the MADIT -CRT populationwas evaluated.At follow-up end, the rate of death from any cause in patients receiving cardiac resynchronization therapy and defibrillation was 18% versus 29% of those randomized to defibrillation alone (p <0.001).Resynchronization therapy was not associated with any clinical benefit or harm even in patients without LBBB.
Conclusion
In patients with mild symptoms of heart failure, ventricular dysfunction and complete left bundle branch block, early intervention with cardiac resynchronization therapy plus defibrillation is associated with a significant survival benefit in the long term.
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Ilan Goldenberg
2014-03-31
Original title: Long-term Survival with Cardiac Resynchronization Therapy in Patients with Mild Heart Failure.