February 4th, 2015
To Shock or Not to Shock — That Is the Question
Joseph G Akar, MD/PhD and Jehad Al Buraiki, MD
Jehad Al Buraiki and Joseph G. Akar offer differing perspectives, from each side of the Atlantic, on cardiac resynchronization-pacemaker therapy.
March 30th, 2014
MADIT-CRT Long-Term Follow-Up Shows Survival Benefit with CRT-D
Larry Husten, PHD
MADIT-CRT was an influential trial that showed a reduction in heart failure complications — but not mortality — when cardiac resynchronization therapy (CRT) was added to an implantable defibrillator in patients with mild heart failure who also had left bundle-branch block (LBBB). Patients in the trial were followed for 2.4 years, raising questions about the long-term effects […]
September 3rd, 2013
Study Fails to Support Broader Patient Population for Cardiac-Resynchronization Therapy
Larry Husten, PHD
A new study from the Echo-CRT study group shows that CRT is not beneficial in patients with HF and a narrow QRS complex and may even be harmful.
August 26th, 2013
New Subcutaneous ICD Said to Pose ‘Existential Crisis’ for Older ICDs
Larry Husten, PHD
Last year the FDA approved Boston Scientific’s subcutaneous ICD (S-ICD), the first ICD that doesn’t use transvenous leads. Those leads are the source of many sophisticated pacing features in today’s ICDs, but they are also the main source of ICD-related complications. FDA approval of the S-ICD was based on a pivotal trial designed to assess the […]
July 17th, 2013
A Surprising ICD Revision
Westby G Fisher, MD, James Fang, MD and Edward J. Schloss, MD
An ICD removed from a 70-year-old man has a startling appearance. Explain what you think happened, and offer your approach for how to care for this patient.
January 7th, 2013
Selections from Richard Lehman’s Literature Review: January 7th
Richard Lehman, BM, BCh, MRCGP
This week’s topics include a study of survival among patients receiving a primary prevention ICD in clinical practice vs. clinical trials and the RELAX-AHF trial, which examined treatment of acute HF with serelaxin.
September 12th, 2011
Study Finds Risks and Costs Associated with Infection After Device Implantation
Larry Husten, PHD
A large new study has found significant risks and costs associated with infections following the implantation of CIEDs (cardiovascular implantable electronic devices), including ICDs, CRT-Ds, and pacemakers. In a paper published in Archives of Internal Medicine, Muhammad Sohail and colleagues analyzed Medicare data from more than 200,000 patients admitted for CIED implantation, replacement, or revision in 2007, including 5817 admissions with infection. Infection […]
August 29th, 2011
Not Shocking: French Studies Evaluate Remote Monitoring of ICDs
Larry Husten, PHD
Remote monitoring of ICDs can reduce inappropriate shocks, but the overall clinical benefit and cost-effectiveness of the technology has not yet been demonstrated, according to two new studies presented at the ESC meeting in Paris. Salem Kacet presented the ECOST (Effectiveness and Cost of ICD Follow-Up Schedule with Telecardiology) study in which 433 ICD patients were […]
November 14th, 2010
A Life-RAFT for Patients with HF?
Arthur J. Moss, MD
CardioExchange welcomes Arthur Moss, Professor of Medicine at the University of Rochester School of Medicine and lead investigator of the MADIT-CRT trial, to discuss his New England Journal of Medicine editorial on the RAFT trial, in which patients with mild-to-moderate HF were randomized to receive either an ICD alone or ICD plus CRT. It seems […]
November 14th, 2010
ICD-CRT Found Beneficial in RAFT
Larry Husten, PHD
RAFT (Resynchronization-Defibrillation for Ambulatory Heart Failure Trial) randomized 1798 patients with NYHA class II or III heart failure, LVEF < 30%, and a wide QRS complex to either an ICD alone or an ICD-CRT. After a mean followup of 40 months, the rate of death or heart failure hospitalization was 40.3% in the ICD group […]