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Cardiac resynchronization therapy 

Cardiac resynchronization therapy
Chapter:
Cardiac resynchronization therapy
Author(s):

Dr Ricardo Petraco

, Dr Ricardo Petraco

, Dr Larry Mulligan

, and Dr Francisco Leyva

DOI:
10.1093/med/9780199594764.003.0014
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date: 23 October 2019

The effect of heart failure on survival is comparable to cancer. Despite advances in pharmacological therapy, over half of all patients die within four years of the diagnosis and more than a third die within one year of a first hospitalization. In addition, heart failure has a devastating effect on quality of life, similar to that associated with a stroke, chronic haemodyalisis, and motor neurone disease.

The development of cardiac resynchronization therapy (CRT) over the past decade marks a new era of device therapy for patients with heart failure. Evidence supporting CRT initially emerged from single case studies and small patient series. Subsequently, the findings of large randomized controlled trials have placed CRT firmly within clinical guidelines for the treatment of heart failure. The increasing demand for CRT is testament to the evidence-based practice that characterises modern cardiology.

This is an opportune time to reflect on the history of CRT research. From over 3000 published studies and reviews on the subject, we have selected the ten papers which we feel most adequately represent the evolution of CRT research over the years. Prominent in our approach for this review is the intention to illustrate how research has evolved from exploration of first principles to the emergence of clinically applicable findings from randomized controlled trials.

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