BMJ  2003;326:1073-1077 (17 May), doi:10.1136/bmj.326.7398.1073

Clinical review

Science, medicine, and the future

New pacing technologies for heart failure

¹ Department of Cardiology, Royal Berkshire and Battle Hospital, Reading RG30 1AJ, ² Department of Cardiology, St Mary's Hospital, London W2 1NY, ³ Cardiac Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London SW3 6LY

Heart failure is a sizeable problem in elderly populations, and although pharmacological treatment has improved, outcome generally remains poor. New pacing technologies have been developed to treat heart failure, with promising results

The first 150 words of the full text of this article appear below.

Introduction

The prevalence of heart failure in the general population is estimated to be 1-2% and increases rapidly with age.¹ In developed countries heart failure is a leading cause of admission to hospital among elderly patients and accounts for 1-2% of healthcare expenditure.² Although several pharmacological treatments have improved outcome,^3–5 the prognosis of patients with heart failure remains poor. Alternative non-pharmacological approaches including cardiac transplantation have been limited by availability of organs, and the use of artificial left ventricular assist devices remains restricted.

Recently, several promising new developments have taken place in pacing technology to treat selected patients with heart failure. These include atrio-biventricular pacing to correct abnormal patterns of left ventricular contraction and implantable cardiac defibrillators for treatment of malignant ventricular arrhythmias. As the scale of the problem becomes apparent new treatments that have been shown to improve morbidity and possibly mortality in patients with chronic heart failure will undoubtedly . . . [Full text of this article]

Methods

Sources and search criteria
The heart failure population
Ventricular dyssynchrony
Pacing for the treatment of heart failure
Cardiac resynchronisation
Effects of biventricular pacing
Clinical trials of biventricular pacing
Limitations and complications of biventricular pacing
Implantable cardioverter defibrillators

Conclusion

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