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Eur Heart J. 2006 Feb;27(3):323-9. Epub 2005 Aug 16.

How many patients with heart failure are eligible for cardiac resynchronization? Insights from two prospective cohorts.

Author information

1
The Division of General Internal Medicine, 2E3.24 Walter Mackenzie Health Sciences Centre, University of Alberta, 8440 112 Street, Edmonton, Alberta T6G 2R7, Canada. finlay.mcalister@ualberta.ca

Abstract

AIMS:

To determine what proportion of patients with heart failure are eligible for cardiac resynchronization therapy (CRT).

METHODS AND RESULTS:

Eligibility criteria from the trials establishing the efficacy of CRT were applied to two prospective cohorts: the first enrolled patients with newly diagnosed heart failure discharged from 103 hospitals between April 1999 and March 2001 ('the hospital discharge cohort'); the second enrolled patients seen in a specialized clinic between August 2003 and January 2004 ('the specialty clinic cohort'). In the hospital discharge cohort, 73 patients (3% of the 2640 patients with ischaemic or dilated cardiomyopathy and 1% of all 9096 patients with heart failure discharged alive) met trial eligibility criteria: LVEF< or =0.35, QRS > or =120 ms, sinus rhythm, and NYHA class III or IV symptoms despite the treatment with ACE-inhibitor/angiotensin receptor blocker and beta-blocker. In the specialty clinic cohort, 54 patients (21% of the 263 patients with ischaemic or dilated cardiomyopathy and 17% of all 309 patients with heart failure) met these criteria. If persistent symptoms despite taking spironolactone were required for CRT eligibility, then the proportions qualifying dropped to 1% in the hospital discharge cohort and 18% in the specialty clinic cohort.

CONCLUSION:

Few heart failure patients meet trial eligibility criteria for CRT.

PMID:
16105850
DOI:
10.1093/eurheartj/ehi446
[Indexed for MEDLINE]

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