QRS ≥ 130 ms CRT group: LBBB (761)/RBBB (136) control: LBBB (520)/RBBB (92)ĬRT combined with ICD decreased the risk of HF events in relatively asymptomatic patients with a low ejection fraction and wide QRS complex.Įvaluate the long-term effects of CRT in the European cohort of patients enrolled in the REVERSE trial. N = 1,820 randomized to CRT (CRT and ICD on) group (1,089)/control (CRT off and ICD on) (731) followed for up of 2.4 years N = 610 randomized to CRT group (419)/control (191) followed for 12 monthsĬRT in combination with optimal medical therapy (+/-defibrillator), reduces the risk for HF hospitalization and improves ventricular structure and function in NYHA I and II.ĭetermine whether CRT with biventricular pacing would reduce the risk of death or HF events in patients with NYHA I or II, reduced EF of ≤ 30% and QRS duration ≥ 130 ms. The broader the QRS in general the overall better results.Īssess the effects of CRT use in patients with NYHA functional class I and II. N = 813 randomized to CRT group (409)/control (404) followed for 18 monthsĬRT improves symptoms, the QOL and reduces complications and improves mortality. CRT did not alter exercise capacity.Įvaluation of CRT on morbidity and mortality in patients with NYHA class III or IV. Significant improvement in cardiac structure and function over 6 months. QRS ≥ 130 ms CRT group: LBBB 88%/RBBB 12% non-CRT group: LBBB 79%/RBBB 21% N = 186 randomized to CRT on (86)/control (101) followed for 6 months L)Īssess the efficacy and safety of combined CRT and ICD therapy in patients with NYHA class II CHF despite appropriate medical management. CRT effect on QOL score and NYHA functional class was not influenced by morphology of the BBB (R vs. QRS ≥ 130 ms CRT group: LBBB 87%/RBBB 13% control group: LBBB 86%/RBBB 14%ĬRT improved quality of life, functional status, and exercise capacity in patients with moderate to severe HF, a wide QRS interval, and life-threatening arrhythmias. N = 369 randomized to CRT on (187)/ CRT off (182) followed for 6 months QRS ≥ 120 ms CRT group: LBBB 50%/NSIVCD 32%/RBBB 18% non-CRT group: LBBB 54%/NSIVCD 34%/RBBB 12%ĬRT implant has improved the functional status in all patients that were indicated for ICD and have HFrEF and IVCD.Įxamine the efficacy and safety of combined CRT and ICD therapy in patients with NYHA class III or IV CHF despite appropriate medical management. N = 490 randomized to CRT (245)/control (245) followed for 6 months Significant clinical improvement in moderate to severe heart failure with IVCD.Īssess the safety and effectiveness of cardiac CRT when combined with an ICD. N = 453 randomized to CRT group (228)/control (225) followed for 6 months QRS ≥ 120 ms LBBB, 39 (93%)/ RBBB, 3 (7%)ĬRT produces a long-term improvement in the clinical symptoms of patients with HF who have significant IVCD.Įvaluate the clinical benefit of CRT in symptomatic heart failure with IVCD. N = 42 randomized to biventricular CRT (24)/univentricular CRT (17) followed for 9 months CHF: congestive heart failure CRT: cardiac resynchronization therapy NYHA: New York Heart Association ICD: implantable cardioverter defibrillator IVCD: intraventricular conduction delay NSIVCD: nonspecific interventricular conduction delay LVEF: left ventricular ejection fraction LBBB: left bundle branch block RBBB: right bundle branch block QOL: quality of life HFrEF: heart failure with reduced ejection fraction LBFB: left posterior fascicular block LAFB: left anterior fascicular block LV: left ventricular RV: right left ventricular AV: atrioventricular.Ĭompare the short- and long-term clinical effects of atrial synchronous, pre-excitation of univentricular or biventricular therapy with cardiac CRT. The trials consist of patients of varying classes of NYHA, using different endpoints such as rehospitalization or mortality, the cohort however is primarily LBBB or non-specified QRS prolongation. Most of these trials do not have any subgroup analysis of patients with non-LBBB. ![]() The table summarized all landmark trials influencing CRT guidelines since 2002. Summary of the CRT Landmark Clinical Trials Only since 2016 can we see the gap beginning to narrow. Line-graph representing the volume of patients studied over time, both LBBB/unspecified (blue) and specified non-LBBB (red).
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