Defibrillator Longevity Study: Has Your Research Impacted Your Decision Making?

So the question is how has this
changed my practice? And it really has changed it. I mean, I did a fairly generous blend of manufacturers’
devices when picking a de novo CRT system in 2009 and as time has gone on, I have really
especially in younger patients, I’ve really opted for the longer-lasting device because
fundamentally they do the same thing. I don’t really have anything compelling, the
adaptive CRT data is interesting as far as allowing some intrinsic conduction and that
may be beneficial but for the most part, we still believe if you have a big ugly left
bundle, Class III heart failure and a low EF and we CRT you, it doesn’t really matter. As long as you are CRT pacing and pre-exciting
the left ventricle, restoring synchrony, those patients respond and clinically we see that,
especially MADIT CRT is a good example of that. Those are not adaptive CRT patients but they
have a pretty impressive extension in longevity of the patient as well as potentially the
devices in the system. So when I start thinking about well, if I’m
going to put this in for a 49-year-old woman with a non-ischemic cardiomyopathy in a left
bundle, I really want to minimize the number of times I have to go back in there and I
tend to choose up front a device that’s going to last longer. So, it’s impacted our practice.

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