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David J. Bradley, MD, PhD

JAMA. 2003;289:2719-2721.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Despite major advances in pharmacological therapy during the past 2 decades,^1-2 heart failure is associated with more than 280 000 deaths annually in the United States.³ The most common modes of death among patients with symptomatic heart failure are sudden cardiac death and death from progressive heart failure.² Two classes of implantable cardiac devices, implantable cardioverter defibrillators (ICDs) and cardiac resynchronization devices, separately address these modes of death in heart failure. Implantable cardioverter defibrillators can terminate potentially lethal ventricular arrhythmias by pacing or shocking the heart. In high-risk patients, ICDs reduce sudden cardiac death by 57% relative to usual care and improve overall survival.⁴ Implantable cardioverter defibrillators, however, generally do not improve quality of life.⁵

Cardiac resynchronization therapy (CRT), also called atrial synchronized biventricular pacing, is a more recently developed pacemaker-based technology that corrects the underlying dyssynchronous left ventricular contraction that is common in failing hearts.^6-7 . . . [Full Text of this Article]

Author Affiliation: Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md.

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