In patients with the condition, known as left bundle branch block or LBBB, CRT-D therapy reduced heart failure progression and the risk of ventricular tachyarrhythmias, fast and potentially life-threatening heart rhythms. Heart failure patients without LBBB did not receive any benefit from the therapy.
The analysis, based on the major study which tested the device – the MADIT-CRT trial – led the FDA to extend the approval of the CRT-D in September 2010 to patients with mild heart failure and LBBB to prevent progression to advanced heart failure. The device, developed by Boston Scientific, was originally approved to treat patients with severe heart failure.
Cardiac resynchronization therapy with defibrillator (CRT–D)“This study allowed us to identify the specific set of patients that receive the greatest benefit from this device,” said Wojciech Zareba, M.D., Ph.D., lead study author and director of the Heart Research Follow-up Program at the University of Rochester Medical Center. “Our analysis highlights the fact that this therapy is not equally effective in all mild heart failure patients and was the basis of the FDA’s approval of the therapy only in patients with left bundle branch block.”
Zareba’s team found that patients with LBBB who received CRT-D therapy had a significant 53 percent reduction in the risk of a heart failure event, such as being hospitalized with heart failure symptoms, or death, compared to LBBB patients who only received an implantable cardioverter defibrillator (ICD). The risk of ventricular tachyarrhythmias was also considerably less in LBBB patients with CRT-D.
Arthur J. Moss, M.D.CRT-D therapy combines an ICD, which senses dangerous abnormal heart rhythms and attempts to shock the heart back into a normal rhythm, with cardiac resynchronization therapy (CRT), which coordinates the beating of the heart so it can pump blood throughout the body more effectively.
The study included 1,817 patients and researchers analyzed electrocardiograms – maps of the heart’s electrical activity – to determine which patients had electrical disturbances and what type. Seventy percent of study participants had LBBB. LBBB patients were more often female and had higher rates of non-ischemic heart disease, a disorder typically characterized by inflammatory scarring of the heart muscle.
Study authors evaluated the effects of CRT-D versus ICD therapy in patients with and without LBBB. They found that in LBBB patients, CRT-D therapy effectively prevented deterioration of the heart, otherwise known as cardiac remodeling, by preventing enlargement of the heart with more effective contraction of the heart.
“We believe this therapy is so effective in patients with LBBB because their hearts don’t contract in a synchronous way, rather, the pumping action is quite out of sync,” noted Zareba. “CRT-D therapy paces the heart and makes these patients much better very quickly.”
Beyond mild heart failure patients, the results are leading experts to rethink current guidelines recommending the use of CRT-D therapy for all advanced heart failure patients. In this age of personalized medicine, as treatments are continually directed towards subsets of patients with particular characteristics or biologic markers, the group of advanced heart failure patients that receive CRT-D therapy may be narrowed to those with LBBB, as well.
The MADIT-CRT trial, led by Arthur J. Moss, M.D., cardiologist at the University of Rochester Medical Center, was supported by a research grant from Boston Scientific to the University of Rochester. The sub-analysis, led by Zareba, was also sponsored by Boston Scientific.For Media Inquiries:
Emily Boynton | EurekAlert!
Using fragment-based approaches to discover new antibiotics
21.06.2018 | SLAS (Society for Laboratory Automation and Screening)
Scientists learn more about how gene linked to autism affects brain
19.06.2018 | Cincinnati Children's Hospital Medical Center
In a recent publication in the renowned journal Optica, scientists of Leibniz-Institute of Photonic Technology (Leibniz IPHT) in Jena showed that they can accurately control the optical properties of liquid-core fiber lasers and therefore their spectral band width by temperature and pressure tuning.
Already last year, the researchers provided experimental proof of a new dynamic of hybrid solitons– temporally and spectrally stationary light waves resulting...
Scientists from the University of Freiburg and the University of Basel identified a master regulator for bone regeneration. Prasad Shastri, Professor of...
Moving into its fourth decade, AchemAsia is setting out for new horizons: The International Expo and Innovation Forum for Sustainable Chemical Production will take place from 21-23 May 2019 in Shanghai, China. With an updated event profile, the eleventh edition focusses on topics that are especially relevant for the Chinese process industry, putting a strong emphasis on sustainability and innovation.
Founded in 1989 as a spin-off of ACHEMA to cater to the needs of China’s then developing industry, AchemAsia has since grown into a platform where the latest...
The BMBF-funded OWICELLS project was successfully completed with a final presentation at the BMW plant in Munich. The presentation demonstrated a Li-Fi communication with a mobile robot, while the robot carried out usual production processes (welding, moving and testing parts) in a 5x5m² production cell. The robust, optical wireless transmission is based on spatial diversity; in other words, data is sent and received simultaneously by several LEDs and several photodiodes. The system can transmit data at more than 100 Mbit/s and five milliseconds latency.
Modern production technologies in the automobile industry must become more flexible in order to fulfil individual customer requirements.
An international team of scientists has discovered a new way to transfer image information through multimodal fibers with almost no distortion - even if the fiber is bent. The results of the study, to which scientist from the Leibniz-Institute of Photonic Technology Jena (Leibniz IPHT) contributed, were published on 6thJune in the highly-cited journal Physical Review Letters.
Endoscopes allow doctors to see into a patient’s body like through a keyhole. Typically, the images are transmitted via a bundle of several hundreds of optical...
13.06.2018 | Event News
08.06.2018 | Event News
05.06.2018 | Event News
21.06.2018 | Life Sciences
21.06.2018 | Earth Sciences
21.06.2018 | Life Sciences