Implantable left ventricular assist systems: clinical trials

Cleland, John G.F.; Mohaçsi, Paul; Murphy, Richard L.W.

doi:10.1016/s1388-9842(00)00059-3

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…At least two randomized controlled trials of left ventricular assist systems are now under way 104 , 105 . These studies are small but conducted in very high‐risk subgroups of patients with heart failure.…”

Section: Left Ventricular Assist Systemsmentioning

confidence: 99%

Outcome Studies with Device Therapy in Patients with Heart Failure

Cleland

Thackray

Goodge

et al. 2002

Cardiovasc electrophysiol

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Device Therapy for Heart Failure. Heart failure is a common debilitating condition for which pharmacologic therapy thus far has provided only partial relief. Despite, and sometimes because of, medical therapy, the overall prognosis remains poor, with high rates of sudden death and death from progressive heart failure. Device-based therapies offer considerable promise for relief of symptoms and for improving prognosis. It is clear that implantable defibrillators should be considered for patients with heart failure who have been resuscitated from ventricular fibrillation or sustained ventricular tachycardia. Several large studies currently are investigating the effects of implantable defibrillators on total mortality in patients with major left ventricular systolic dysfunction but without other risk factors for sudden death. Cardiac resynchronization is a promising new therapy that may relieve the symptoms of heart failure in appropriately selected patients resistant to optimal pharmacologic therapy. Two large trials (CARE-HF and COMPANION) currently are investigating the effects of cardiac resynchronization therapy (CRT) on morbidity and mortality. It is important that those involved in these trials enroll patients quickly and minimize device implantation into patients who have not been assigned this therapy (cross-overs). Overenthusiasm for the benefits that doctors believe devices might bring could destroy the future basis for our clinical practice, denying future generations of patients and the doctors themselves access to what they believe to be effective treatments.

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Section: Left Ventricular Assist Systemsmentioning

confidence: 99%

Outcome Studies with Device Therapy in Patients with Heart Failure

Cleland

Thackray

Goodge

et al. 2002

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Although the study result is positive, it has to be questioned whether the benefits to patients is cost‐effective, given the expense of the device and the continuing patient care, or worthwhile, given the high morbidity and poor quality of life during the extra months of life conferred. The outcome of other trials in progress are keenly awaited [18]. However, considering the dramatic advances in the science and technology of LVADs since the inception of the REMATCH trial it is almost certain that the next trial, for there must surely be several others, will show a dramatically lower morbidity with device therapy.…”

Section: End‐stage Heart Failurementioning

confidence: 99%