A study of patients with chronic heart failure shows that implanted devices can help them survive and stay out of the hospital.
What the researchers wanted to know: For patients with chronic heart failure, does getting a pacemaker reduce the risk of dying or being hospitalized? What if it's combined with an implanted defibrillator?
What they did: A group of researchers signed up 1,520 patients with advanced heart failure at 128 hospitals across the United States. Each patient was randomly put in one of three groups: they were given heart drugs alone, heart drugs and a pacemaker, or heart drugs and a combined pacemaker and defibrillator. A pacemaker sends out electric impulses that keep the heart beating regularly; a defibrillator jump-starts the heart if its beat gets out of whack. The drugs, unless a patient didn't need or couldn't handle one or more, were diuretics, ACE inhibitors, beta-blockers, and spironolactonewhat the researchers considered the optimum drugs for advanced heart failure. After putting the patients into one of the groups, the researchers kept track of how long it took for each patient to go into the hospital or die.
What they found: The devices helped. Patients with pacemakers or pacemaker-defibrillators had a lower risk of dying or going into the hospital than patients who were only taking drugs. Also, patients with pacemaker-defibrillators were likely to live longer than patients with just pacemakers.
Caveats: The research was supported by medical device maker Guidant. However, Guidant had no part in data analysis.
What this study means to you: To the millions of people with heart failure, getting a pacemaker may be a lifesaver.
Find out more: The study was published in the New England Journal of Medicine on May 20, 2004. Read about implantable defibrillators (http://www.americanheart.org/presenter.jhtml?identifier=11227) and pacemakers (http://www.americanheart.org/presenter.jhtml?identifier=4676) at the American Heart Association (www.americanheart.org). Go to www.implantable.com for active discussion boards for people with implanted pacemakers and defibrillators.
Read the article: Bristow, M.R. et al. Cardiac-resynchronization Therapy With or Without an Implantable Defibrillator in Advanced Chronic Heart Failure. New England Journal of Medicine. May 20, 2004, vol. 350, pp. 2140-2150.