Implants Protect People With Heart Failure
Advanced Pacemakers, ICDs Reduce Risk of Death for Those With Heart Failure
May 19, 2004 -- For most people with severe heart failure and irregular heartbeats, a combination of a high-tech pacemaker and implantable defibrillator may provide the best protection against death, according to new research.
Researchers say the results of the two major studies published in this week's New England Journal of Medicine may lead to wider use of the devices in people with severe heart failure -- a condition in which the heart cannot pump enough blood to meet the body's needs.
The pacemakers studied not only help the heart keep up when its natural beat is too slow like traditional pacemakers, but they also make the heart pump more efficiently. Meanwhile, an implantable cardioverter defibrillator (ICD) delivers an electrical shock to prevent potentially dangerous heart rhythm abnormalities.
In the first study, researchers compared the effectiveness of the advanced pacemaker and implantable defibrillator vs. drug therapy in preventing hospitalization or death in people with advanced heart failure. They found the devices offered the greatest benefits, and use of both reduced the risk of death in patients with severe heart failure by 36%.
The second study showed that implanting a defibrillator in people with heart failure not caused by coronary artery disease or hardening of the arteries significantly reduced their risk of sudden death. People with this type of heart failure often die suddenly due to an irregular heartbeat.
Devices Beat Drug Therapy Along for Heart Failure
The first study looked at whether adding a pacemaker or ICD to traditional drug therapy for heart failure provided additional health benefits in reducing the risk of death or hospitalization for more than 1,500 people with advanced heart failure.
The heart failure patients were randomly assigned to receive drug therapy (including diuretics, ACE inhibitors, beta-blockers, and others), alone or in combination with either a pacemaker or a pacemaker-defibrillator combination.
Researchers found that compared with drug therapy alone, use of a pacemaker reduced the risk of death or hospitalization from any cause by 19%, and use of both devices reduced the risk by 20%.
Overall, the study showed that use of a pacemaker reduced the risk of death from any cause by 24%, and the combination pacemaker-defibrillator reduced the risk by 36%.