Winter
2012

Discovery

Rethinking Pacemakers In Heart Failure Treatment

Rethinking Pacemakers In Heart Failure Treatment

Three-lead pacemakers might not be worth the risk and expense for nearly half of the heartfailure patients who use them, according to research from Case Western Reserve School of Medicine and University Hospitals Case Medical Center. The devices are commonly used to coordinate the contractions of the heart’s chambers in patients suffering from congestive heart failure. But an in-depth analysis found that nearly 40 percent of patients saw no benefit from the treatment.

Current guidelines recommend pacemakers for heart failure patients with a specific EKG abnormality called QRS prolongation of 0.12 seconds or longer. However, the analysis shows pacemakers only benefit patients with QRS prolongation greater than 0.15 seconds—leaving a group of patients with less severe electrical disturbances in their hearts without effective treatment.

Ilke Sipahi, MD, adjunct assistant professor of medicine at the School of Medicine, led the investigation along with James Fang, MD, professor of medicine at the medical school and director of clinical cardiovascular services at University Hospitals Case Medical Center. He says revising the criteria for implanting pacemakers based on the study’s results could help avoid thousands of unnecessary implants and cut down on unwarranted costs.