Cardiovascular Medicine Book

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Cardiac Resynchronization Therapy

Aka: Cardiac Resynchronization Therapy, Cardiac Resynchronization Implantable Device
  1. See Also
    1. Implantable Defibrillator
    2. Pacemaker
    3. Left Ventricular Assist Device (LVAD)
  2. Indications: ACA/AHA and ESC/EHRA
    1. Ejection Fraction <30-35%
    2. NYHA Class 2-4 Heart Failure despite stable optimal medical therapy
    3. QRS Duration > 120 msec
      1. CRT did not show mortality or hospitalization benefit for QRS Duration 120-150 msec in meta-analysis
      2. Sipahi (2011) Arch Intern Med 171(16): 1454-62 [PubMed]
  3. Contraindications
    1. Cardiogenic Shock
    2. Symptomatic Hypotension while in stable baseline rhythm
    3. Coronary revascularization (CABG or PTCA) within last 3 months
    4. Acute Myocardial Infarction within 40 days
    5. Clinical findings necessitating coronary revascularization
    6. Irreversible brain damage from cerebral disease
    7. Life Expectancy <1 year from other comorbidities
  4. References
    1. McAlister (2007) JAMA 297(22):2502-14 [PubMed]
    2. Tang (2010) N Engl J Med 363(25): 2385-95 [PubMed]

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