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Therapeutics
Cardiac resynchronisation was effective for moderate to severe heart failure with intraventricular conduction delay

https://doi.org/10.1136/ebm.7.6.172

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    (2002) N Engl J Med. 346, 1845; Abraham WT, Fisher WG, Smith AL, et al, for the MIRACLE Study Group.. Cardiac resynchronisation in chronic heart failure.. ;. :. –53.
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 QUESTION: In patients with moderate to severe heart failure and an intraventricular conduction delay, does cardiac resynchronisation improve clinical outcomes?

    Design

    Randomised (unclear allocation concealment*), blinded (unclear),* controlled trial with 6 month follow up (Multicenter InSync Randomised Clinical Evaluation [MIRACLE]).

    Setting

    45 centres in the United States and Canada.

    Patients

    453 patients (mean age 64 y, 68% men) who had moderate or severe (New York Heart Association [NYHA] functional class III or IV) chronic heart failure resulting from ischaemic or non-ischaemic cardiomyopathy; received stabilised doses of medication for ≥1 month (≥3 mo for β-blockers); and had left ventricular ejection fraction ≤35%, a QRS interval ≥130 msec, and a 6 minute walking distance ≤450 m. Exclusion criteria included use of pacemakers or cardioverter-defibrillators, a cardiac or cerebral ischaemic …

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