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Apr 24, 2014

Treating Mild Heart Failure with CRT

Study pinpoints heart failure patients that might benefit from cardiac resynchronization therapy.

The list of treatment options for heart failure patients just got a little longer, based on evidence presented at the American College of Cardiology’s 63rd Annual Scientific Session.

A recent study called the MADIT-CRT trial tested the use of cardiac resynchronization therapy (CRT) in treating patients with mild heart failure. This type of therapy involves implanting a small pacemaker below the collarbone to monitor the heart rate and correct any abnormal heartbeats that come about. Typically, CRT is reserved for patients with moderate to severe heart failure with an abnormal heart rhythm because it helps maintain normal heart rhythm and relieve debilitating symptoms like shortness of breath. But researchers wondered if this treatment might also benefit patients with mild heart failure, who don’t have many symptoms. After all, past studies suggest that CRT may decrease risk of complications and death in heart failure patients.

More than 1,800 patients with heart failure participated in the MADIT-CRT trial. All patients received an ICD (implantable cardioverter defibrillator), which detects and stops abnormal heartbeats, and roughly 60% of these participants received CRT on top of standard treatment.

After following patients for seven years, researchers found that CRT only benefits certain types of patients. The addition of CRT helped reduce risk of heart events and death in patients with a specific condition called left bundle branch block (LBBB). However, patients without this condition didn’t benefit from the additional therapy. In fact, findings suggest that CRT actually increases certain risks in this specific group of heart failure patients.

The good news is that study findings help pinpoint exactly which patients benefit from certain heart failure therapy. Based on data from the MADIT-CRT trial, doctors can use heart devices more intelligently in heart failure patients. Of course, further research is needed to better understand when CRT is appropriate but experts are encouraged by these findings. Nearly 5 million Americans are currently living with heart failure and the more treatment options we have, the better their quality of life will be.

Questions for You to Consider

  • What is cardiac resynchronization therapy?
  • Cardiac resynchronization therapy (CRT) is often used in patients with moderate to severe heart failure who have arrhythmia, the most common type of irregular heartbeat. Patients undergoing CRT have a small pacemaker implanted in their chest, which monitors the heart rate and corrects any abnormal heart rhythms. CRT has been shown to alleviate heart failure symptoms, including shortness of breath, and improve outcomes.
  • What is an implantable cardioverter defibrillator (ICD)?
  • An ICD is a device that uses electrical pulses or shocks to help patients with an irregular heartbeat maintain normal heart rhythm. Upon detecting an abnormal heart rhythm, ICDs send shocks to the heart to help restore normal rhythm and prevent sudden cardiac death.


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