Patients with heart block see strong benefit from cardiac resynchronization therapy
Heart failure patients with a condition called "heart block" derive significant benefit from cardiac resynchronization therapy (CRT), according to the results of the Block HF clinical trial, presented today at the American Heart Association Scientific Sessions 2012 meeting in Los Angeles.
Anne B. Curtis, MD, Charles and Mary Bauer Professor and Chair of Medicine in the University at Buffalo School of Medicine and Biomedical Sciences and principal investigator of Block HF, presented results of the eight-year-long, national, multicenter, randomized clinical trial sponsored by Medtronic, Inc., which enrolled more than 900 patients. Curtis discusses the results in this video:
This video is not supported by your browser at this time."These findings confirm what some clinicians and researchers have hypothesized for some time—that heart failure patients with heart block do better when both sides of the heart are resynchronized, called biventricular pacing, using a cardiac resynchronization therapy (CRT) device," she says. "The results of Block HF may lead to a reassessment of treatment guidelines for heart failure patients with heart block."
In the trial, 349 patients underwent biventricular pacing with a CRT device and 342 patients underwent the conventional right ventricular pacing. Patients who underwent biventricular pacing had a 26 percent reduction in the combined endpoint of mortality, heart-failure related urgent care and deterioration in heart function detected by echocardiography.
There also was a 27 percent relative risk reduction in the composite endpoint of heart failure urgent care and all-cause mortality.
The Block HF trial was designed to address the best way to treat atrioventricular block (AV block), a partial or complete block in the main "trunk" of the heart's electrical conduction system.
"AV block prevents electrical impulses from reaching the bottom chambers of the heart, which then beat very slowly or not at all," explains Curtis.
To treat AV block, many patients are implanted with a standard pacemaker with leads or pacing wires in the top chamber (right atrium) and the bottom chamber (right ventricle) of the heart. "But that fix can lead to other problems," Curtis says, "such as creating less synchrony between the left and right ventricles of the heart, making their heart failure symptoms even worse."
Researchers and clinicians have hypothesized that better outcomes might result from pacing both the left and right ventricles of the heart, called biventricular pacing, which involves implanting a cardiac resynchronization therapy device.
"Implanting these devices is more complicated than putting in a standard pacemaker, something clinicians don't want to put patients through without clear evidence of a benefit," says Curtis. "Today, we are announcing that Block HF does show that benefit."
Heart failure affects approximately 6 million people in the U.S. at a cost of somewhere between $20 and 56 billion/year. Of those, AV block affects more than 800,000 Americans and more than a million people worldwide.
Curtis, a UB faculty member since 2010, is one of the world's leading clinical cardiac electrophysiologists and an expert in cardiac arrhythmias. Her clinical research has significantly advanced knowledge of human cardiac electrophysiology and heart rhythm abnormalities.
Her research interests include clinical trials in implantable device therapy for prevention of sudden cardiac death and management of heart failure, as well as clinical trials in atrial fibrillation. She has been principal investigator, co-investigator, sponsor or steering committee member on 85 research studies and clinical trials and she has written more than 250 peer-reviewed manuscripts, book chapters, reviews and editorials. She also is author of a book on cardiac pacing.
Provided by University at Buffalo
- Chronic right ventricular pacing works for ICD patients with left ventricular dysfunction Mar 26, 2012 | not rated yet | 0
- Most eligible patients miss out on cardiac resynchronization therapy for heart failure Dec 11, 2009 | not rated yet | 0
- Deaths reduced with cardiac resynchronization therapy Jan 31, 2011 | not rated yet | 0
- New therapy found to prevent heart failure Jun 23, 2009 | not rated yet | 0
- HFSA updates recommendations for use of cardiac resynchronization therapy Feb 27, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
The Durability of Bone: Long Falls
8 hours ago I am doing a paper on the physics in Valve's Portal and got interested in the "Long Fall Boots" that prevent any damage no matter how far you fall. I...
Is energy convertible to matter?
9 hours ago Can we convert energy to matter?
Rotating electron as a dipole is this right?
12 hours ago An electron as shown by the Stern Gerlach experiment behaves like a dipole (albeit only in one of two states). I have been trying to figure out how...
Dipole term in multipole expansion
16 hours ago Hi. I'm having some difficult in understanding something about the dipole term in a multipole expansion. Griffiths writes the expansion as a sum of...
Bubbles in a Pre-Boiling/Boiling pot of water
17 hours ago How is it that bubbles form on the bottom of a surface of a pot of boiling water? I think that there is probably an elementary answer to this...
Assumptions of Griffith's fracture theory
May 21, 2013 Any experts on Griffith's fracture theory? I am studying the subject and I am having hard time finding out if the theory is valid for all possible...
- More from Physics Forums - Classical Physics
More news stories
The Orsiro stent, which is a novel stent platform eluting sirolimus from a biodegradable polymer, demonstrated non-inferiority to the Xience Prime everolimus-eluting stent for the primary angiographic endpoint of in-stent ...
Cardiology 13 hours ago | 5 / 5 (1) | 0
One-year results from SOURCE XT – one of the largest, post-approval transcatheter aortic valve implantation (TAVI) registries to-date – reported today at EuroPCR 2013 show good clinical outcomes in routine clinical practice, ...
Cardiology 13 hours ago | not rated yet | 0
A drug commonly used to treat depression and anxiety may improve a stress-related heart condition in people with stable coronary heart disease, according to researchers at Duke Medicine.
Cardiology 14 hours ago | 5 / 5 (1) | 0 |
(Medical Xpress)—In a recent subgroup analysis of the largest blood pressure treatment trial in history, University of Alabama at Birmingham (UAB) researchers found that women and men react the same to ...
Cardiology 22 hours ago | 5 / 5 (1) | 0
Is it permissible to harm one to save many? Those who tend to say "yes" when faced with this classic dilemma are likely to be deficient in a specific kind of empathy, according to a report published in the scientific journal ...
1 hour ago | not rated yet | 0 |
Phthalates: Study links chemicals widely found in plastics, processed food to elevated blood pressure in children, teens
Plastic additives known as phthalates (pronounced THAL-ates) are odorless, colorless and just about everywhere: They turn up in flooring, plastic cups, beach balls, plastic wrap, intravenous tubing and—according to the ...
2 hours ago | not rated yet | 1 |
(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...
19 hours ago | 4.2 / 5 (5) | 0 |
(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...
17 hours ago | 4.9 / 5 (14) | 0 |
Australian scientists have charted the path of insulin action in cells in precise detail like never before. This provides a comprehensive blueprint for understanding what goes wrong in diabetes.
19 hours ago | 4.6 / 5 (7) | 0 |
Activating an enzyme known to play a role in the anti-aging benefits of calorie restriction delays the loss of brain cells and preserves cognitive function in mice, according to a study published in the May ...
13 hours ago | 5 / 5 (5) | 0 |