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Posts Tagged ‘madit crt’

ICDs have revolutionizes the management of refractory VT   and in the  prevention of  sudden cardiac deaths in vulnerable population.Every year  100s of  thousand    ICDs are    implanted . Three  industry leaders are providing  state of  art  machines. The technology is evolving . Till recently , the  shocking leads of ICD has  a separate connectors  called DF1 .

Now,  we have all 4 leads incorporated into one lead  connector called  DF 4 . It has gained tremendous interest  among cardiologist and stand alone electro-physiologists  . The reason is simple  – Ease  of   implantation !

Does the  ease of implanting  do compromise   the  efficiency of ICD  system ?

I am surprised by this article . Here is an  excellent analysis by a truth seeking   electro-physiologist  about the   genuine issues of ICD implantation  especially to potential problems with  DF 4 interface .

http://www.cardioexchange.org/voices/new-icd-lead-technology-creates-new-set-of-problems-a-perspective-from-one-electrophysiologist/

A related article .

https://drsvenkatesan.wordpress.com/wp-admin/post.php?post=19708&action=edit

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Cadiac resynchrnonisation (CRT) therapy , is  the most famed  as well as  ridiculed treatment modality for refractory failure . It is facing a real tough time for survival now .(At least in class 4 CHF.)

Confident and  authentic data  are emerging  now , that CRT should not be  used  in advanced heart failure .(This is in total contrast with the original concept  ,  when CRT was introduced nearly  a decade ago !  more  of class 3 and 4 were enrolled ) . Bad outcomes are expected in advanced CHF. This is something similar to whipping the tired horse concept  which  found inotropes   to increase the mortality in severe heart failure .

The article in the current issue of circulation  shows  no mercy to CRT  in advanced CHF

http://circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.110.956011v1

So what  is  the answer to the ailing CRT industry ?

Go and catch class 1 and class 2 CHF population* .You will get plenty  , of course  it got ratified by MADIT -CRT trial .

* It is attractively called prevention of cardiac failure

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