This week, a new report has demonstrated that women have better health success than men when comparisons of cardiac resynchronization therapy defibrillators (CRT-Ds) usage are analyzed. Women simply received a greater clinical benefit from than men.

In approximately 30% of patients with heart failure, an abnormality in the heart’s electrical conducting system causes the two ventricles to beat in an asynchronous fashion. Meaning that the two ventricles beat slightly out of phase of together. This asynchrony greatly reduces the efficiency of the ventricles in patients with heart failure, whose hearts are already damaged.

CRT syncs up the beating of the two ventricles by pacing both ventricles simultaneously. This differs from typical pacemakers, which pace only the right ventricle. When the work of the two ventricles is coordinated, the heart’s efficiency increases, and the amount of work it takes for the heart to pump blood is reduced.

Studies with CRT have demonstrated its ability to improve the symptoms, the exercise capacity, and the feeling of well-being of many patients with moderate to severe heart failure. Studies have also shown that CRT can improve both the anatomy and function of the heart – tending to reduce the size of the dilated left ventricle, and therefore improving the left ventricular ejection fraction. Perhaps most importantly, CRT can improve the survival of patients with heart failure.

It has been discovered thatwomen experienced a 70% reduction in heart failure events compared to a 35% reduction for men.

Kenneth Stein, M.D., Senior Vice President and Chief Medical Officer, CRM, for Boston Scientific’s Cardiology, Rhythm and Vascular Group states:

“CRT-D therapy has historically been underutilized in women compared to men with the same severity of heart disease. Boston Scientific believes that all patients, regardless of gender, should have equal access to high-quality cardiovascular care. We believe these findings will help draw attention to the benefits of CRT-D treatment for women, and therefore help reduce treatment disparities between women and men.”

MADIT-CRT is the world’s largest randomized CRT-D study of New York Heart Association (NYHA) Class I and II patients with more than 1,800 patients enrolled at 110 centers worldwide. Results of the MADIT-CRT trial were published in the October 2009 issue of the New England Journal of Medicine.

According to The American Heart Association, cardiac resynchronization therapy is a relatively new therapy for patients with symptomatic heart failure resulting from systolic dysfunction. Published clinical trials have demonstrated that CRT results in improved clinical status and lower mortality rate when selected patients with systolic ventricular dysfunction and heart failure are treated with CRT. This advisory identifies appropriate candidates for CRT on the basis of the inclusion criteria and results from the published clinical trials.

The risks associated with the implantation of a CRT device are relatively small and are similar to the risks and complications associated with the transvenous implantation of a conventional permanent pacemaker or implantable defibrillator. These risks include bleeding, infection, hematoma, pneumothorax, pericardial effusion with or without tamponade and myocardial infarction, stroke, and death.

Transvenous implantation of a left ventricular lead for CRT is accomplished via the coronary sinus and its tributaries. The specific risks associated with implantation of a left ventricular lead for CRT include coronary sinus dissection and perforation, lead dislodgment, extracardiac stimulation and the risks associated with intravenous contrast, including acute renal failure. Limited data suggest that ventricular proarrhythmia may be a rare but potential risk of CRT.

Source: Boston Scientific

Written by Sy Kraft, B.A.