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

To the Editor: In their meta-analysis, Dr Bradley and colleagues¹ concluded that cardiac resynchronization reduces mortality from progressive heart failure in patients with symptomatic left ventricular dysfunction. We have several concerns, however, about their representation and interpretation of current data.

First, the review is incomplete because it failed to include at least 1 published randomized trial,² in which no deaths occurred; excluded another³ without explanation; and only partially reported data in the public domain for a third.⁴

All published studies have randomized patients only after they had survived successful device implantation. These trials are blinded, proof-of-concept studies to assess whether cardiac resynchronization could improve symptoms, ventricular function, and exercise capacity. They were not, however, designed to determine the effects of cardiac resynchronization on morbidity and mortality.

Recently the Comparison of Medical Therapy, Pacing and Defibrillation in Chronic Heart Failure study comparing optimal medical therapy with cardiac resynchronization alone or cardiac . . . [Full Text of this Article]

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