Medtronic
 
 

Heart Failure

CRT Combined with an Implantable Cardioverter Defibrillator

Heart failure patients are six to nine times more likely than the general population to experience ventricular arrhythmias that can lead to sudden cardiac death (SCD).1 Yet until recently, there was little clinical evidence to support the use of an ICD for the primary prevention of SCD (i.e., ICD therapy to protect against VT/VF in high risk patients who have never had a spontaneous, life-threatening ventricular arrhythmia) in patients with impaired ventricular function. This changed after the MADIT II trial, which demonstrated a clear mortality benefit of ICDs in heart failure patients with ischemic or nonischemic disease.2

The MIRACLE ICD trial, while not powered to detect mortality or morbidity differences between the control (ICD with no CRT pacing) and CRT group (ICD with CRT pacing), did show that CRT, without interfering with ICD functions, improved the quality of life, functional capacity, and cardiopulmonary exercise test performance of patients with moderate to severe HF, a wide QRS interval, and life-threatening ventricular arrhythmias.3

For this reason, Medtronic offers a full line of ICD, CRT, and CRT+ICD devices to meet the unique device needs of heart failure patients.

References
  1. American Heart Association. Heart Disease and Stroke Statistics - 2004 Update. Dallas, Tex.: American Heart Association; 2003.
  2. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, Daubert JP, Higgins SL, Brown MW, Andrews ML; Multicenter Automatic Defibrillator Implantation Trial II Investigators. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 2002; 346(12): 877-883.
  3. Young JB, Abraham WT, Smith AL, Leon AR, Lieberman R, Wilkoff B, Canby RC, Schroeder JS, Liem LB, Hall S, Wheelan K for The Multicenter InSync ICD Randomized Clinical Evaluation (MIRACLE ICD) Trial Investigators.
    Combined cardiac resynchronization and implantable cardioverter defibrillation in advanced chronic heart failure. The MIRACLE ICD Trial. JAMA 2003; 289:2685-2694.

 

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