Resynchronization therapy with pacemakers cuts mortality by half and hospitalizations by almost one third among patients with heart failure, according to an article in the February 12th issue of the Journal of the American Medical Association.

"The devices range in cost from $20,000 to $50,000 [USD]," said lead author David J. Bradley, M.D., Ph.D. "These specialized pacemakers have been known to improve the quality of life for heart failure patients, but whether they also save lives had been unclear."

Heart failure is the cause of more than 700,000 hospitalizations among elderly Americans every year. Advances in technology have increased the number diagnosed with heart failure each year to about 550,000 people, said senior author Neil R. Powe, M.D., M.P.H. "We can often save heart attack patients with drugs like thrombolytics or with angioplasty, but they survive with weakened hearts, and often progress to heart failure or other troubles," he noted.

In the current work, researchers analyzed the literature for randomized, controlled trials comparing pacemaker resynchronization with no therapy and found four eligible trials involving a total of 1,634 patients, the majority of whom were men ages 63 to 66 years with moderate to severe heart failure.

Cardiac resynchronization involves placement of a pacemaker lead in a coronary vein over the left ventricle to improve ventricular function. Successful treatment improves exercise capacity and quality of life among patients.

In the analysis, cardiac resynchronization reduced death from progressive heart failure by 51 percent. The death rate was 1.7 percent for patients who underwent pacemaker resynchronization and 3.5 percent for those who did not receive any treatment. Pacemaker therapy reduced hospitalizations by 29 percent and showed a trend toward reducing mortality due to any cause.

Bradley noted that the mortality rates themselves were low because follow-up periods ranged only from 3 to 6 months. Larger-scale and longer-term trials may better indicate the strength of improvement in outcome with resynchronization therapy.