Heart Failure Treatments Offer New Hope
"Beta-blockers are not being used enough in the treatment of heart failure patients," says Pinski, who wrote an editorial accompanying the two studies. "It has become clear that almost every patient with systolic dysfunction or heart failure should be on a beta-blocker." Pinski is head of cardiac pacing in the cardiology department of Cleveland Clinic Florida.
In the other JAMA study, researchers from Baltimore's Johns Hopkins Medical Institutions reported that implantation of a specialized pacemaker reduced deaths by half and reduced hospitalization by a third among 1,634 heart failure patients.
Lead researcher David J. Bradley, MD, PhD, and colleagues reviewed four clinical trials comparing patients with heart failure who got the special pacemakers with those who did not get them. Patients who received the pacemaker therapy, known as cardiac resynchronization, had improved heart function, improved exercise capacity, and improved quality of life. At three to six months follow-up, 1.7% of the pacemaker patients had died compared with 3.5% of those without pacemakers. Heart failure-related hospitalizations were also reduced by 29% among pacemaker patients.
Bradley tells WebMD that pacemakers represent a promising treatment option for patients who have had few options in the past. The devices may also allow patients to tolerate larger doses of beta-blocker drugs.
"Beta-blockers tend to slow the heart down, but the pacemakers prevent that from happening," he says. "Right now we don't know just how big an impact there will be for patients treated with both of these therapies, but it is very exciting."