CARDIAC RESYNCHRONIZATION THERAPY: IMPROVING QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH HEART FAILURE

Abstract

Just 30 years ago, the hope for survival in patients
with heart failure (CHF) was dismal and centered on
heart transplantation as the ultimate therapy1.Some of the early hemodynamic studies of abnormal
ventricular activation in dilated cardiomyopathy
(DCM) patients were done by Xiao et alIn 1998 LeClerc and Cazeau demonstrated the acute
hemodynamic effects of biventricular pacing in
patients with end-stage heart failure19.Buoyed by the gratifying observation that systolic
function is influenced by pacing the posterolateral
LVsite, Yu et al turned their attention to changing the
timing of atrial contraction as it relates to ventricular
contraction.In previous trials lasting up to six months, CRT has
shown decrease in symptoms and improvement in
exercise capacity, quality of life, and ventricular
function19,25,26.In Pakistan the hospital ‘package’ for a CRT implant
can range from less than Rs. 400,000 for a CRT
pacemaker to Rs. 1,200,000 for CRT Pacemaker-ICD
combination.Ten studies have reported on CRT peri-implant
morbidity and mortality. There were 13 deaths in
3,113 patients (0.4%).