Cardiac resynchronisation therapy for the treatment of heart failure
This is an extract from the guidance and may be misleading if read alone. The complete guidance is available at guidance.nice.org.uk/ta120
1 Guidance
This guidance should be read in conjunction with 'Implantable cardioverter defibrillators for arrhythmias' (NICE technology appraisal guidance 95 – see appendix C). This guidance on cardiac resynchronisation therapy provides additional treatment options for some of the groups of people covered in the guidance on implantable cardioverter defibrillators (ICDs).
1.1 Cardiac resynchronisation therapy with a pacing device (CRT-P) is recommended as a treatment option for people with heart failure who fulfil all the following criteria.
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They are currently experiencing or have recently experienced New York Heart Association (NYHA) class III–IV symptoms.
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They are in sinus rhythm:
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either with a QRS duration of 150 ms or longer estimated by standard electrocardiogram (ECG)
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or with a QRS duration of 120–149 ms estimated by ECG and mechanical dyssynchrony that is confirmed by echocardiography.
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They have a left ventricular ejection fraction of 35% or less.
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They are receiving optimal pharmacological therapy.
1.2 Cardiac resynchronisation therapy with a defibrillator device (CRT-D) may be considered for people who fulfil the criteria for implantation of a CRT-P device in section 1.1 and who also separately fulfil the criteria for the use of an ICD device as recommended in NICE technology appraisal guidance 95.