In this large trial of patients with class II-III CHF, EF<30%, and wide QRS, who received an ICD, they were randomized to+/- cardiac resynchronization therapy (CRT). Those in the resynchronization group had significantly fewer hospitalizations for CHF or all-cause death (primary outcome, occurred in 33% vs 40% of the groups). However, 13% of the CRT group experienced a device/implant-related adverse event, compared to only 7% of the non-CRT group. CRT can improve CHF hospitalization rates and all-cause death, at the expense of device-related adverse events (including pneumothorax, hemothorax, hematoma, infection, lead dislodgement, and coronary sinus dissection) (abstract)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.