- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Cardiac resynchronization therapy reduces death, HF hospitalization in patients with IVCD but not RBBB: Circulation
USA: Cardiac resynchronization therapy reduces heart failure hospitalization (HFH) or death in intraventricular conduction delay (IVCD) but not right bundle branch block (RBBB), indicating that the two conditions should not be lumped together, findings from a meta-analysis have shown.
The study, published in the journal, Circulation, found that in patients with IVCD or left bundle branch block (LBBB), cardiac resynchronization therapy (CRT) helped outcomes but not for those with RBBB. The researchers suggest reconsidering aggregating RBBB and IVCD into a single "non-LBBB" category during patients' selection for CRT.
The benefit from cardiac resynchronization therapy differs by QRS characteristics; individual randomized trials are underpowered to evaluate usefulness for relatively small subgroups. Daniel J Friedman from Duke University School of Medicine in Durham, NC, and colleagues analyzed patient-level data from pivotal CRT trials: MIRACLE, MIRACLE-ICD, MIRACLE-ICD II, REVERSE, RAFT, BLOCK-HF, MADIT-CRT, and COMPANION using Bayesian Hierarchical Weibull survival regression models.
They assessed CRT benefit by QRS morphology (LBBB, n=4549, RBBB, n=691; and IVCD, n=1024 and duration (with 150-ms partition). The primary endpoint was time to death or heart failure hospitalization; a secondary endpoint was time to all-cause death.
The study led to the following findings:
· Of 6264 patients included, 25% were women, the median age was 66 [interquartile range, 58 to 73] years, and 61% received CRT (with or without an implantable cardioverter defibrillator).
· CRT was associated with an overall lower risk of HFH or death (hazard ratio [HR], 0.73), and in subgroups of patients with QRS ≥150 ms and either LBBB (HR, 0.56) or IVCD (HR, 0.59), but not RBBB (HR 0.97).
· No significant association for CRT with HFH or death was observed when QRS was <150 ms (regardless of QRS morphology) or in the presence of RBBB. Similar relationships were observed for all-cause death.
"Cardiac resynchronization therapy in patients with QRS ≥150 ms and LBBB or IVCD is associated with reduced death or hospitalization for heart failure but not for those with RBBB," the researchers wrote.
"Lumping RBBB and IVCD together into a single "non-LBBB" category should be reconsidered when selecting patients for CRT," they conclude.
Reference:
Friedman DJ, Al-Khatib SM, Dalgaard F, Fudim M, Abraham WT, Cleland JGF, Curtis AB, Gold MR, Kutyifa V, Linde C, Tang AS, Ali-Ahmed F, Olivas-Martinez A, Inoue LYT, Sanders GD. Cardiac Resynchronization Therapy Improves Outcomes in Patients With Intraventricular Conduction Delay But Not Right Bundle Branch Block: A Patient-Level Meta-Analysis of Randomized Controlled Trials. Circulation. 2023 Jan 26. doi: 10.1161/CIRCULATIONAHA.122.062124. Epub ahead of print. PMID: 36700426.
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751