La insuficiencia cardiaca es una de las enfermedades más prevalentes en los países desarrollados. La morbilidad y la mortalidad de los pacientes con insuficiencia cardiaca sigue siendo importante pese a los avances en la terapia farmacológica. En los últimos años, los resultados de diversos ensayos clínicos han conducido a la incorporación del desfibrilador automático implantable y la estimulación biventricular (o terapia de resincronización cardiaca) en el tratamiento de los pacientes con insuficiencia cardiaca crónica. El propósito de esta revisión es, por tanto, presentar la evidencia disponible para la utilización de estos dispositivos en la práctica clínica habitual.
Palabras clave
Insuficiencia cardiaca
Resincronización cardiaca
Desfibrilador automático implantable
Muerte súbita
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Bibliografía
[1.]
K. MacIntyre, S. Capewell, S. Stewart, J.W. Chalmers, J. Boyd, A. Finlayson, et al.
Evidence of improving prognosis in heart failure: trends in case fatality in 66547 patients hospitalized etween 1986 and 1995.
Circulation, (2000), 102 pp. 1126-1131
[2.]
P.A. Poole-Wilson, B.F. Uretsky, K. Thygesen, J.G. Cleland, B.M. Massie, L. Ryden, Atlas Study Group.
Assessment of treatment with lisinopril and survival. Mode of death in heart failure: findings from the ATLAS trial.
Heart, (2003), 89 pp. 42-48
[3.]
J.G. Cleland, J.C. Daubert, E. Erdmann, N. Freemantle, D. Gras, L. Kappenberger, et al.
The effect of cardiac resynchronization on morbidity and mortality in heart failure.
N Engl J Med, (2005), 352 pp. 1539
[4.]
C. Leclercq, J.M. Hare.
Ventricular resynchronization current state of the art.
Circulation, (2004), 109 pp. 296-300
[5.]
S. Baldasseroni, C. Opasich, M. Gorini, D. Lucci, N. Marchionni, M. Marini, et al.
Left bundle branch clock is associated with increased 1-year sudden an total mortality rate in 5517 outpatients with congestive heart failure: a report from the Italian network on congestive heart failure.
Am Heart J, (2002), 143 pp. 398
[6.]
M.G. St John Sutton, T. Plappert, W.T. Abraham, A.L. Smith, D.B. DeLurgio, A.R. Leon, et al.
Effect of cardiac resynchronization therapy on left ventricular size and function in chronic heart failure.
Circulation, (2003), 107 pp. 1985-1991
[7.]
W.F. Kerwin, E.H. Botvinick, J.W. O’Connell, S.H. Merrick, T. DeMarco, K. Chatterjee, et al.
Ventricular contraction abnormalities in dilated cardiomyopathy effect of biventricular pacing to correct interventricular dyssynchrony.
J Am Coll Cardiol, (2000), 35 pp. 1221-1227
[8.]
J. Sundell, E. Engblom, J. Koistinen, A. Ylitalo, A. Naum, K.Q. Stolen, et al.
The effects of cardiac resynchronization therapy on left ventricular function, myocardial energetic and metabolic reserve in patients with dilated cardiomyopathy and heart failure.
J Am Coll Cardiol, (2004), 43 pp. 1207-1212
[9.]
C.M. Yu, E. Chau, J.E. Sanderson, K. Fan, M.O. Tang, W.H. Fung, et al.
Tissue Doppler echocardiographic evidence of reserve remodeling and improved synchronicity by simultaneously delaying regional contraction after biventricular pacing therapy in heart failure.
Circulation, (2002), 105 pp. 438
[10.]
C.M. Yu, G.B. Bleeker, J.W. Fung, M.J. Schalij, Q. Zhang, E.E. Van der Wall, et al.
Left ventricular reverse remodelling but no clinical improvement predicts long germ survival after cardiac resynchronization therapy.
Circulation, (2005), 112 pp. 1580-1585
[11.]
C. Leclercq, S. Cazeau, H. Le Breton, P. Ritter, P. Mabo, D. Gras, et al.
Acute hemodynamic effects of biventricular DDD pacing in patients with end-stage heart failure.
J Am Coll Cardiol, (1998), 32 pp. 1825
[12.]
J.M. Aranda Jr, G.W. Woo, J.B. Conti, R.S. Schofield, C.R. Conti, J.A. Hill.
Use of cardiac resynchronization therapy to optimize beta blockers therapy in patients with heart failure and prolonged QRS duration.
Am J Cardiol, (2005), 95 pp. 889-893
[13.]
A.D. Waggoner, M.N. Faddis, M.J. Gleva, L. De las Fuentes, V.G. Davila-Roman.
Improvement in left ventricular diastolic function after cardiac resynchronization therapy are coupled to response in systolic performance.
J Am Coll Cardiol, (2005), 46 pp. 2244
[14.]
C. Ermis, R. Seutter, A.X. Zhu, L.C. Benditt, L. VanHeel, S. Sakaguchi, et al.
Impact of upgrade to cardiac resynchronization therapy on ventricular arrhythmic frequency in patients with implantable cardioverter-defibrillation?.
J Am Coll Cardiol, (2005), 46 pp. 2258
[15.]
C. Fantoni, S. Raffa, F. Regoli, F. Giraldi, M.T. La Rovere, J. Prentice, et al.
Cardiac resynchronization therapy improves heart rate profile and heart rate variability of patients with moderate to severe heart failure.
J Am Coll Cardiol, (2005), 46 pp. 1875
[16.]
L.A. Saxon, W.G. Stevenson, H.R. Middlekauff, L.W. Stevenson.
Increased risk of progressive hemodynamic deterioration in advanced heart failure patients requiring permanent pacemakers.
Am Heart J, (1993), 125 pp. 1306-1312
[17.]
M.R. Bristow, L.A. Saxon, J. Boehmer, S. Krueger, D.A. Kass, T. De Marco, et al.
Cardiac resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure.
N Engl J Med, (2004), 350 pp. 2140
[18.]
G.B. Bleeker, M.J. Schalij, S.G. Molhoek, E. Boersma, P. Steendijk, E.E. Van der Wall, et al.
Comparation of effectiveness of cardiac resynchronization therapy in patients < 70 versus 70 years of age.
Am J Cardiol, (2005), 96 pp. 240
[19.]
S.A. Strickberger, J. Conti, E.G. Daoud, E. Havranek, M.R. Mehra, I.L. Pina, et al.
Patients selection for cardiac resynchronization therapy. AHA Science Advisory.
Circulation, (2005), 111 pp. 2146-2150
[20.]
V.A. Medina-Ravell, R.S. Lankipalli, G.X. Yan, C. Antzelevitch, N.A. Medina-Malpica, O.A. Medina-Malpica, et al.
Effect of epicardial or biventricular pacing to prolong QT interval and increase transmural dispersion of repolaritation. Does resynchronization therapy pose a risk for patients predisposed to QT or torsade de pointes?.
Circulation, (2003), 107 pp. 740-746
[21.]
F.A. McAlister, J.A. Ezekowitz, N. Wiebe, B. Rowe, C. Spooner, E. Crumley, et al.
Systematic review. Cardiac resynchronization in patients with symptomatic heart failure.
Ann Intern Med, (2004), 141 pp. 381-392
[22.]
W.T. Abraham, W.G. Fisher, A.L. Smith, D.B. Delurgio, A.R. Leon, E. Loh, et al.
Cardiac resynchronization in chronic heart failure.
N Engl J Med, (2002), 346 pp. 1845
[23.]
J.B. Young, W.T. Abraham, A.L. Smith, A.R. Leon, R. Lieberman, B. Wilkoff, et al.
Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure. The MIRACLE ICD Trial.
JAMA, (2003), 289 pp. 2685-2691
[24.]
A. Auricchio, C. Stellbrink, S. Sack, M. Block, J. Vogt, P. Bakker, et al.
Long-term clinical effect of hemodynamically optimized cardiac resynchronization therapy in patients with heart failure an ventricular conduction delay.
J Am Coll Cardiol, (2002), 39 pp. 2026-2032
[25.]
C. Stellbrink, O.A. Breithardt, A. Franke, S. Sack, P. Bakker, A. Auricchio, T. Pochet, R. Salo, A. Kramer, J. Spinelli.
Impact of cardiac resynchronization therapy using hemodynamically optimized pacing on left ventricular remodeling in patients with congestive heart failure and ventricular conduction disturbances.
J Am Coll Cardiol, (2001), 38 pp. 1957-1965
[26.]
S.L. Higgins, J.D. Hummel, I.K. Niazi, M.C. Giudici, S.J. Worley, L.A. Saxon, et al.
Cardiac resynchronization therapy for the treatment of heart failure in patients with intraventricular conduction delay and malignant ventricular tachyarrhythmias.
J Am Coll Cardiol, (2003), 42 pp. 1454-1462
[27.]
J.J. Bax, G.B. Bleeker, T.H. Marwick, S.G. Molhoek, E. Boersma, P. Steendijk, et al.
Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy.
J Am Coll Cardiol, (2004), 44 pp. 1839-1842
[28.]
M.R. Mehra, B.H. Greenberg.
Cardiac resynchronization therapy: caveat medicus¿.
J Am Coll Cardiol, (2004), 43 pp. 1145
[29.]
G.B. Bleeker, M.J. Schalij, S.G. Molhoek, H.F. Verwey, E.R. Holman, E. Boersma, et al.
Relation between QRS duration and left ventricular dissynchrony in patients with end-stage heart failure.
J Cardiovasc Electrophysiol, (2004), 15 pp. 544-561
[30.]
J.J. Bax, G. Ansclone.
Echocardiographic evaluation of cardiac resynchronization therapy: ready for routine clinical use? A critical approach.
J Am Coll Cardiol, (2004), 44 pp. 1834-1841
[31.]
G.Y. Cho, J.K. Song, W.J. Park, S.W. Han, S.H. Choi, Y.C. Doo, et al.
Mechanical dyssynchrony assessment by Tissue Doppler imaging is a powerful predictor of mortality in congestive heart failure with normal QRS duration.
J Am Coll Cardiol, (2005), 46 pp. 2237-2243
[32.]
W.T. Abraham, J.B. Young, A.R. Leon, S. Adler, A.J. Bank, S.A. Hall, et al.
Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter defibrillation and mildly symptomatic chronic heart failure.
Circulation, (2004), 110 pp. 2864-2871
[33.]
C. Leclercq, S. Walker, C. Linde, J. Clementy, A.J. Marshall, P. Ritter, et al.
Comparative effects of permanent biventricular and right univentricular pacing in heart failure with chronic atrial fibrillation.
Eur Heart J, (2002), 23 pp. 1780
[34.]
R.N. Doshi, E.G. Daoud, C. Fellows, K. Turk, A. Duran, M.H. Hamdan, et al.
Mortality and congestive heart failure in the PAVE study.
Europace, (2004), 6
[35.]
J.J. Blanc, V. Bertault-Valls, M. Fatemi, M. Gilard, P.Y. Pennec, Y. Etienne.
Midterm benefits of left univentricular pacing in patients with congestive heart failure.
Circulation, (2004), 109 pp. 1741
[36.]
L.A. Saxon.
If only rights were really lefts.
J Cardiovasc Electrophysiol, (2005), 16 pp. 120
[37.]
K. Swedberg, J. Cleland, H. Dargie, H. Drexler, F. Follath, M. Komajda, et al.
Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology.
Eur Heart J, (2005), 26 pp. 1115-1140
[38.]
S.A. Hunt, W.T. Abraham, M.H. Chin, A.M. Feldman, G.S. Francis, T.G. Ganiats, et al.
ACC/AHA 2005 Guideline Update for the diagnosis and management of chronic heart failure in the adult.
Circulation, (2005), 112 pp. e154-235
[39.]
D.J. Wilber, B. Olshansky, J.F. Moran, P.J. Scanlon.
Electrophysiological testing and nonsustained ventricular tachycardia. Use and limitations in patients with coronary artery disease and impaired ventricular function.
Circulation, (1990), 82 pp. 350-358
[40.]
A.J. Moss, W.J. Hall, D.S. Cannom, J.P. Daubert, S.L. Higgins, H. Klein, et al.
Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators.
N Engl J Med, (1996), 335 pp. 1933-1940
[41.]
A.E. Buxton, K.L. Lee, J.D. Fisher, M.E. Josephson, E.N. Prystowsky, G. Hafley.
A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators.
N Engl J Med, (1999), 341 pp. 1882-1890
[42.]
A.I. Mushlin, W.J. Hall, J. Zwanziger, E. Gajary, M. Andrews, R. Marron, et al.
The cost-effectiveness of automatic implantable cardiac defibrillators: results from MADIT. Multicenter Automatic Defibrillator Implantation Trial.
Circulation, (1998), 97 pp. 2129-2135
[43.]
A.E. Buxton, K.L. Lee, L. DiCarlo, M.R. Gold, G.S. Greer, E.N. Prystowsky, et al.
Electrophysiologic testing to identify patients with coronary artery disease who are at risk for sudden death. Multicenter Unsustained Tachycardia Trial Investigators.
N Engl J Med, (2000), 342 pp. 1937-1945
[44.]
A.J. Moss, W. Zareba, W.J. Hall, H. Klein, D.J. Wilber, D.S. Cannom, et al.
Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction.
N Engl J Med, (2002), 346 pp. 877-883
[45.]
J.T. Bigger Jr..
Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronaryartery bypass graft surgery. Coronary Artery Bypass Graft (CABG) Patch Trial Investigators.
N Engl J Med, (1997), 337 pp. 1569-1575
[46.]
S.H. Hohnloser, K.H. Kuck, P. Dorian, R.S. Roberts, J.R. Hampton, R. Hatala, et al.
Prophylactic use of an implantable cardioverterdefibrillator after acute myocardial infarction.
N Engl J Med, (2004), 351 pp. 2481-2488
[47.]
G.H. Bardy, K.L. Lee, D.B. Mark, J.E. Poole, D.L. Packer, R. Boineau, et al.
Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure.
N Engl J Med, (2005), 352 pp. 225-237
[48.]
A. Kadish, A. Dyer, J.P. Daubert, R. Quigg, N.A. Estes, K.P. Anderson, et al.
Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy.
N Engl J Med, (2004), 350 pp. 2151-2158
[49.]
A.S. Desai, J.C. Fang, W.H. Maisel, K.L. Baughman.
Implantable defibrillators for the prevention of mortality in patients with nonischemic cardiomyopathy: a meta-analysis of randomized controlled trials.
JAMA, (2004), 292 pp. 2874-2879
[50.]
K. Nanthakumar, A.E. Epstein, G.N. Kay, V.J. Plumb, D.S. Lee.
Prophylactic implantable cardioverter-defibrillator therapy in patients with left ventricular systolic dysfunction: a pooled analysis of 10 primary prevention trials.
J Am Coll Cardiol, (2004), 44 pp. 2166-2172
[51.]
G.D. Sanders, M.A. Hlatky, D.K. Owens.
Cost-effectiveness of implantable cardioverter-defibrillators.
N Engl J Med, (2005), 353 pp. 1471-1480
[52.]
L. Goldman.
Cost-effectiveness in a flat world-can ICDs help the United States get rhythm?.
N Engl J Med, (2005), 353 pp. 1513-1515
[53.]
J.M. Robert, A. Castellanos.
Clinical research designs and implantable defibrillator indications: spend in the beginning or pay at the end.
J Am Coll Cardiol, (2006), 47 pp. 108-111
[54.]
D.M. Bloomfield, R.C. Steinman, P.B. Namerow, M. Parides, J. Davidenko, E.S. Kaufman, et al.
Microvolt T-wave alternans distinguishes between patients likely and patients not likely to benefit from implanted cardiac defibrillator therapy: a solution to the Multicenter Automatic Defibrillator Implantation Trial (MADIT) II conundrum.
Circulation, (2004), 110 pp. 1885-1889
[55.]
D.M. Bloomfield, J.T. Bigger, R.C. Steinman, P.B. Namerow, M.K. Parides, A.B. Curtis, et al.
Microvolt T-wave alternans and the risk of death or sustained ventricular arrhythmias in patients with left ventricular dysfunction.
J Am Coll Cardiol, (2006), 47 pp. 456-463
[56.]
G. Duray, S. Richter, J. Manegold, C.W. Israel, G. Gronefeld, S.H. Hohnloser.
Efficacy and safety of ICD therapy in a population of elderly patients treated with optimal background medication.
J Interv Card Electrophysiol, (2005), 14 pp. 169-173
[57.]
P. Geelen, A. Lorga Filho, J. Primo, F. Wellens, P. Brugada.
Experience with implantable cardioverter defibrillator therapy in elderly patients.
Eur Heart J, (1997), 18 pp. 1339-1342
[58.]
R. Sheldon, S. Connolly, A. Krahn, R. Roberts, M. Gent, M. Gardner.
Identification of patients most likely to benefit from implantable cardioverter-defibrillator therapy: the Canadian Implantable Defibrillator Study.
Circulation, (2000), 101 pp. 1660-1664
[59.]
J.P. Daubert, H.W. Sesselberg, D.T. Huang.
Implantable cardioverter-defibrillators for primary prevention: how do the data pertain to the aged?.
Am J Geriatr Cardiol, (2006), 15 pp. 88-92
[60.]
D. Bansch, M. Antz, S. Boczor, M. Volkmer, J. Tebbenjohanns, K. Seidl, et al.
Primary prevention of sudden cardiac death in idiopathic dilated cardiomyopathy: the Cardiomyopathy Trial (CAT).
Circulation, (2002), 105 pp. 1453-1458
[61.]
S.A. Strickberger, J.D. Hummel, T.G. Bartlett, H.I. Frumin, C.D. Schuger, S.L. Beau, et al.
Amiodarone versus implantable cardioverterdefibrillator: randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia-AMIOVIRT.
J Am Coll Cardiol, (2003), 41 pp. 1707-1712
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