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Heart Failure Management

Helping you help your heart failure patients feel better with our advanced therapies, monitoring solutions, and management services.

Heart Failure Management

Cardiac resynchronization therapy is a proven treatment for selected heart failure patients with a wide QRS. When used in combination with optimal medical therapy, cardiac resynchronization therapy can improves symptoms and extends survival.1-5

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Clinical Issue

Clinical Issue – Poor Prognosis for Heart Failure Patients with a Wide QRS

Heart failure – related morbidity and mortality remains a major problem6-9

  • Heart failure patients with a wide QRS have poor prognoses6-9
  • Heart failure accounts for over 3.4 million visits to physician offices, hospital outpatient, and emergency departments annually6
  • Heart failure hospitalizations are especially problematic, with one year readmission rates of 50% and mortality rates of approximately 30% 7,8
  • In patients with heart failure, sudden death occurs at four times the rate of the general population9

QRS duration and Left Ventricular Ejection Fraction: Predictors of morbidity and mortality

  • Wide QRS duration is a powerful independent predictor of poor clinical outcomes in patients with HF and reduced left ventricular ejection fraction (LVEF)10
  • QRS durations ≥ 120 ms are associated with a 33% increased risk of all-cause mortality (38% from worsening HF and 31% from sudden death)11
  • Clinical studies show that a low EF is a key predictor of sudden cardiac arrest and an effective way to determine a patient's risk for sudden cardiac arrest (SCA).9,12,13

References

1

Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. April 15, 2005;352(15)1539-1549.

2

Cleland JG, Daubert JC, Erdmann E, et al. Longer-term effects of cardiac resynchronization therapy on mortality in heart failure [the CArdiac REsynchronization-Heart Failure (CARE-HF) trial extension phase]. Eur Heart J. August 2006;27(16):1928-1932.

3

Bristow MR, Feldman AM, Saxon LA. Heart failure management using implantable devices for ventricular resynchronization: Comparison of Medical Therapy, Pacing, and Defibrillation in Chronic Heart Failure (COMPANION) trial. COMPANION Steering Committee and COMPANION Clinical Investigators. J Card Fail. September 2000;6(3):276-285.

4

Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. June 13, 2002;346(24):1845-1853.

5

Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. May 28, 2003;289(20):2685-2694.

6

Burt CW, Schappert SM. Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 1999-2000. Vital Health Stat 13. September 2004;(157):1-70.

7

Kosiborod M, Lichtman JH, Heidenreich PA, et al. National trends in outcomes among elderly patients with heart failure. Am J Med. July 2006;119(7):616.e1-7.

8

Rathore SS, Masoudi FA, Wang Y, et al. Socioeconomic status, treatment, and outcomes among elderly patients hospitalized with heart failure: findings from the National Heart Failure Project. Am Heart J. August 2006;152(2):371-378.

9

Adabag AS, Therneau TM, Gersh BJ, Weston SA, Roger VL. Sudden death after myocardial infarction. JAMA. 2002;300(17):2022-2029.

10

Hawkins NM, Wang D, McMurray JJ, et al. Prevalence and prognostic impact of bundle branch block in patients with heart failure: evidence from the CHARM programme. Eur J Heart Fail. 2007;9(5):510-517.

11

Wang NC, Maggioni AP, Konstam MA, et al. Clinical implications of QRS duration in patients hospitalized with worsening heart failure and reduced left ventricular ejection fraction. JAMA. 2008;299(22):2656-2666.

12

Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440-1463.

13

Priori SG, Aliot E, Blomstrom-Lundqvist C, et al. Task Force on Sudden Cardiac Death of the European Society of Cardiology [published correction appears in Eur Heart J. 2002;23:257]. Eur Heart J. August 2001;22(16):1374-1450.

CRT

CRT Devices

Evidence

Implant

Utilization

OVERVIEW

One in six people will develop heart failure.1,2 More than 670,000 new cases are diagnosed annually in the United States3 — 26 million patients worldwide.3 Heart failure is the most common cause of hospitalizations due to cardiovascular disease in patients over 654. These patients also face many personal challenges:

  • 50% mortality at 5 years5
  • Decreased quality of life
  • Restricted daily activities
  • Increased anxiety

HOW MEDTRONIC CAN HELP

Cardiac Resynchronization Therapy (CRT) is a beneficial way to manage this disease. CRT is proven to6-14:

  • Improve cardiac function
  • Improve quality of life
  • Reduce mortality
  • Reduce heart failure hospitalizations, as well as all-cause 30-day readmissions following a heart failure hospitalization

Our advanced therapies, monitoring solutions, and management services are designed to help you help your heart failure patients feel better —  while improving the efficiency and effectiveness of heart failure care.

OUR VAD SUPPORT

Ventricular Assist Device (VAD) is an effective means of managing advanced heart failure. As this therapy grows, we’re committed to partnering with you to advance the mechanical support field toward meeting these mutual goals:

  • Improve patient care
  • Improve patient quality of life
  • Reduce adverse events
  • Decrease the MCS burden
1

Lloyd-Jones DM, et al. Circulation. 2002;106:3068-3072.

2

Wolinsky FD, et al. Med Care. 1997;35:1031-1043.

3

Ambrosy AP, et al. J Am Coll Cardiol. 2014;63:1123-1133.

4

Cowie MR, et al. Eur Heart J. 1997;18:208-225.

5

Mozaffarian D, et al. Circulation. 2016;133:e38-360.

6

Gold MR, et al. Reduced 30-Day Hospital Readmissions in Systolic Heart Failure Patients with Cardiac Resynchronization Therapy: Evidence from 5 Randomized Controlled Trials. Poster session – November 16, 2014 at AHA 2014.

7

Cleland JG, et al. N Engl J Med. 2005;352:1539-1549.

8

Cleland JG, et al. Eur Heart J. 2006;27:1928-1932.

9

Bristow MR, et al. N Engl J Med. 2004;350:2140-2150.

10

Abraham WT, et al. N Engl J Med. 2002;346:1845-1853.

11

Young JB, et al. JAMA. 2003;289:2685-2694.

12

Linde C, et al. J Am Coll. Cardiol. 2008;52:1834-1843.

13

Tang AS, et al. N Engl J Med. 2010;363:2385-2395.

14

Moss AJ, et al. N Engl J Med. 2009;361:1329-1338.