Thomas Jefferson University Hospital Among First in U.S. to Treat Mild Heart Failure with Implantable Cardiac Device
Thomas Jefferson University Hospital is one of the first hospitals in the United States to treat high-risk asymptomatic or mild heart failure patients with cardiac resynchronization therapy defibrillators (CRT-Ds), which have been clinically proven to reduce death and heart failure events, such as hospitalization. Seventy percent of all heart failure patients in the U.S. are asymptomatic or mildly symptomatic. As one of 110 trial sites worldwide, Thomas Jefferson University Hospital, participated in a landmark clinical trial called MADIT-CRT, that led to the U.S. Food and Drug Administration’s September approval for expanded use of CRT-Ds for early-phase heart failure.
“It was exciting to have participated in such a large and potentially important study,” said Arnold Greenspon, M.D., director,
Cardiac Electrophysiology Laboratory at the
Jefferson Heart Institute. “We now know that early application of CRT-D therapy in high risk patients with minimal symptoms may improve their outcome.”
Mild heart failure typically is treated with lifestyle changes and medicines. However, new research has shown the use of CRT-Ds in asymptomatic or mild heart failure patients, (high-risk New York Heart Association Class I and II patients) with a Left Bundle Branch Block (LBBB), reduces death and heart failure events. CRT-Ds previously were only available to patients in the late phases of the condition. Non-LBBB patients did not show evidence of benefit.
The MADIT-CRT trial sought to determine if early intervention with a CRT-D (which helps to keep the heart in rhythm and has the ability to shock a heart back to normal) could reduce death and heart failure events when compared to a standard implantable cardioverter defibrillators (ICDs) (which can only shock a heart back to normal). However, new data for LBBB patients has shown CRT-Ds were associated with a 57 percent relative reduction in the risk of all-cause mortality or first heart failure events when compared to implantable cardioverter defibrillators (ICDs).
Heart failure results in about 300,000 deaths each year, according to the National Heart, Lung, and Blood Institute. In 2010, heart failure will cost the United States nearly $40 billion. Heart failure cannot be cured but early diagnosis and treatment can improve quality of life and life expectancy for people suffering from heart failure.
About CRT-Ds A
cardiac
resynchronization
therapy device that has a
defibrillator, or CRT-D, improves the heart’s pumping ability by delivering small electrical impulses that help synchronize contractions of the left ventricle, the heart’s main pumping chamber. The small implantable cardiac device also monitors the heart for potentially fatal heart rhythms. If such a rhythm is detected, the CRT-D delivers a lifesaving shock to restore normal heart rhythm and prevent sudden cardiac death, which occurs more frequently in patients with heart failure.
Editors' Note: Boston Scientific was the sole sponsor of this study. All CRT-D’s studied were manufactured by Boston Scientific. Dr. Greenspon is not a paid consultant of the device manufacturer. Media Only Contact:
Richard Cushman
Thomas Jefferson University Hospital
Phone: (215) 955-6300
Published: 10/4/2010