Cardiac Resynchronization Therapy:. Device-Based Medicine for Heart Failure
Bibliographic record
Abstract
Cardiac resynchronization therapy (CRT) or biventricular pacing is a novel adjunctive therapy for patients with advanced heart failure (HF). Many patients with severe HF have a left bundle branch block or an intraventricular conduction delay, with up to 25% of patients with a QRS > 120 ms, resulting in significant left ventricular (LV) dyssynchrony and a high mortality rate. The efficacy of CRT is based on the reduction in the conduction delay between the two ventricles and optimization of the ejection fraction, decrement in mitral regurgitation, LV remodeling, thus resulting in symptom improvement. Cardiac resynchronization therapy can be achieved both transvenously using a coronary sinus branch, or epicardially. Clinical trials have demonstrated a significant improvement in the NYHA class and the exercise capacity as well as a marked reduction in the hospitalization rate. More recently, the COMPANION trial showed a 43% reduction in a composite endpoint of all-cause mortality and hospitalization in the group receiving a CRT device in combination with an implantable cardiac defibrillator (ICD). Thus, management of patients with reduced LV function, wide QRS, and symptomatic refractory HF, despite optimal drug therapy, should include CRT as an option. The adjunct of an ICD combined with CRT should be considered if the LV ejection fraction (ischemic cardiomyopathy) is <30%. There are still significant unanswered questions regarding the nonresponder population and the role of tissue Doppler imaging techniques, the impact of CRT on total mortality and CRT in dilated cardiomyopathy or chronic atrial fibrillation. The use CRT postoperatively or at time of cardiac surgery, as well as new epicardial approaches using a thoracoscopic approach or robotically assisted surgery in patients not suitable for coronary vein leads are challenging topics to address in the years to come.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.034 | 0.026 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".