CARDIAC RESYNCHRONIZATION IN CHRONIC HEART FAILURE

作者：W Illiam T. A Braham, W Estby G. F Isher, L. S Mith, D Avid B. D Elurgio, A Ngel R. L Eon, Eunryul Oh, D Usan Z. K Ocovic, Michael G. Acker, L. C Lavell, D Avid L. H Ayes, M Yrvin E Llestad, J Ohn M Essenger, Miracle S Tudy G Roup · 年份：2002 · 被引用次数：3802 · 研究领域：Cardiac pacing and defibrillation studies、Cardiac Arrhythmias and Treatments、Cardiac electrophysiology and arrhythmias

A BSTRACT Background Previous studies have suggested that cardiac resynchronization achieved through atrialsynchronized biventricular pacing produces clinical benefits in patients with heart failure who have an intraventricular conduction delay. We conducted a double-blind trial to evaluate this therapeutic approach. Methods Four hundred fifty-three patients with moderate-to-severe symptoms of heart failure associated with an ejection fraction of 35 percent or less and a QRS interval of 130 msec or more were randomly assigned to a cardiac-resynchronization group (228 patients) or to a control group (225 patients) for six months, while conventional therapy for heart failure was maintained. The primary end points were the New York Heart Association functional class, quality of life, and the distance walked in six minutes. Results As compared with the control group, patients assigned to cardiac resynchronization experienced an improvement in the distance walked in six minutes (+39 vs. +10 m, P=0.005), functional class (P<0.001), quality of life (i18.0 vs. i9.0 points, P= 0.001), time on the treadmill during exercise testing (+81 vs. +19 sec, P=0.001), and ejection fraction (+4.6 percent vs. i0.2 percent, P<0.001). In addition, fewer patients in the group assigned to cardiac resynchronization than control patients required hospitalization (8 percent vs. 15 percent) or intravenous medications (7 percent vs. 15 percent) for the treatment of heart failure (P<0.05 for both comparison...