Cardiac Resynchronization Therapy Guidelines Updated
(HealthDay News) – The Heart Failure Society of America (HFSA) guidelines have been updated to reflect the latest evidence in support of the expanded use of cardiac resynchronization therapy (CRT) for patients with mild heart failure symptoms.
William G. Stevenson, MD, of the Brigham and Women's Hospital in Boston, and colleagues reviewed the available literature to update the HFSA Guidelines committee on the indications for CRT.
The HFSA recommends CRT in patients with less severe symptoms of heart failure, particularly for those patients in sinus rhythm with QRS duration ≥150ms and without right bundle branch block (RBBB), who, in spite of receiving optimal medical therapy, have severe left ventricular (LV) systolic dysfunction and New York Heart Association (NYHA) functional class II–III symptoms. For several other patient groups, CRT may be considered, including patients with a QRS interval between 120–150ms and with severe LV systolic dysfunction with persistent mild to severe heart failure while receiving optimal medical therapy. Additional patient subgroups that could benefit from CRT therapy include some patients with atrial fibrillation and some with ambulatory NYHA class IV heart failure.
"The totality of evidence supports the use of CRT in heart failure patients with reduced LV ejection fraction across the spectrum of mild to severe symptoms. The evidence is most compelling among patients with QRS duration ≥150ms and without RBBB," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical technology industries.