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CLINICAL REVIEW: Anthony W C Chow, Rebecca E Lane, and Martin R Cowie New pacing technologies for heart failure BMJ 2003; 326: 1073-1077 [Full text]

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Limitation of benefit of CRT in severe heart failure (Class IV)

Munir Emile Nassar, M.D.   (30 May 2003)

Limitation of benefit of CRT in severe heart failure (Class IV) 30 May 2003
Munir Emile Nassar, M.D., consultant V A Community Clinic 14534 Send response to journal: Re: Limitation of benefit of CRT in severe heart failure (Class IV)	Upon reading two articles dealing with cardiac resynchronization therapy (CRT) for heart failure (1),(2), I found that a certain limitation was not mentioned, that class IV heart failure patients already on inotropic medication do not have an added benefit by adding CRT. The latter added therapy was found not to reduce hospitalization nor influence mortality rate between two groups of patients: those on CRT without inotropic medication and those patients with inotropic medication with CRT at 1 year follow up(3). References: 1-Chow et al: New Technologies for Heart failure. BMJ 2003;326,1073-1077 2-Young JB et al: Combined Cardiac Resynchronization and Implantable Cardioversion Defibrillation in Advanced Heart Failure. JAMA 2003;289 No.20, 1685-2694 3-Huneycutt Dc et al: Experience With Cardiac Resynchronization in Heart Failure Patients Requiring Inotropic Support. Pace 2003:26(Pt11): Abstract 451 Competing interests:   None declared