ReviewHeart (British Cardiac Society)2015
Individual patient data network meta-analysis of mortality effects of implantable cardiac devices.
Review in Heart (British Cardiac Society), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 6 syntheses or guidelines pooled it, 140 citations in OpenAlex.
- Global evidence on the cost-effectiveness of cardiac resynchronization therapy for heart failure: a systematic review.Frontiers in cardiovascular medicine · 2026Pooled it
- Clinical practice guidelines for diagnostic and treatment of the chronic heart failure.Archivos de cardiologia de Mexico · 2024Guideline
- Time-trend treatment effect of cardiac resynchronization therapy with or without defibrillator on mortality: a systematic review and meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Pooled it
- The effect of cardiac resynchronization without a defibrillator on morbidity and mortality: an individual patient data meta-analysis of COMPANION and CARE-HF.European journal of heart failure · 2022Pooled it
- Integrating sex and gender in studies of cardiac resynchronization therapy: a systematic review.ESC heart failure · 2022Pooled it
- Efficacy and safety of single-dose 40 mg/kg oral praziquantel in the treatment of schistosomiasis in preschool-age versus school-age children: An individual participant data meta-analysis.PLoS neglected tropical diseases · 2020Pooled it
- Cardiac Resynchronization Therapy With Defibrillator Using the JROAD-DPC Database: Cost-Effectiveness Analysis.Interactive journal of medical research · 2026Article
- CRT-D or CRT-P: When There Is a Dilemma and How to Solve It.Journal of clinical medicine · 2025Review
- Physiological pacing: mechanisms, clinical indications, and perspectives.European heart journal · 2025Review
- Technological Advances and Medical Applications of Implantable Electronic Devices: From the Heart, Brain, and Skin to Gastrointestinal Organs.Biosensors · 2025Review
- Cardiac rhythm devices in heart failure with reduced ejection fraction - role, timing, and optimal use in contemporary practice. European Journal of Heart Failure expert consensus document.European journal of heart failure · 2025Review
- Network Meta-Analysis With Individual Participant-Level Data of Time-to-Event Outcomes Using Cox Regression.Statistics in medicine · 2025Article
- Sex-related similarities and differences in responses to heart failure therapies.Nature reviews. Cardiology · 2024Review
- Predicting long-term survival afterHeliyon · 2024Article
- The intersection of heart failure and cancer in women: a review.Frontiers in cardiovascular medicine · 2024Review
- CRT-D or CRT-P?: the endless debate!Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Effectiveness of adding a defibrillator with cardiac resynchronization therapy in heart failure according to the modified Model for End-stage Liver Disease-Albumin score.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Construction of a web-based dynamic nomogram for predicting the prognosis in acute heart failure.ESC heart failure · 2023Article
- Review
- Conduction system pacing in everyday clinical practice: EHRA physician survey.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
Corrections and comments
- Commented on by
Authors and funding
10 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveImplantable cardioverter defibrillators (ICD), cardiac resynchronisation therapy pacemakers (CRT-P) and the combination therapy (CRT-D) have been shown to reduce all-cause mortality compared with medical therapy alone in patients with heart failure and reduced EF. Our aim was to synthesise data from major randomised controlled trials to estimate the comparative mortality effects of these devices and how these vary according to patients' characteristics.
methodsData from 13 randomised trials (12 638 patients) were provided by medical technology companies. Individual patient data were synthesised using network meta-analysis.
resultsUnadjusted analyses found CRT-D to be the most effective treatment (reduction in rate of death vs medical therapy: 42% (95% credible interval: 32-50%), followed by ICD (29% (20-37%)) and CRT-P (28% (15-40%)). CRT-D reduced mortality compared with CRT-P (19% (1-33%)) and ICD (18% (7-28%)). QRS duration, left bundle branch block (LBBB) morphology, age and gender were included as predictors of benefit in the final adjusted model. In this model, CRT-D reduced mortality in all subgroups (range: 53% (34-66%) to 28% (-1% to 49%)). Patients with QRS duration ≥150 ms, LBBB morphology and female gender benefited more from CRT-P and CRT-D. Men and those <60 years benefited more from ICD.
conclusionsThese data provide estimates for the mortality benefits of device therapy conditional upon multiple patient characteristics. They can be used to estimate an individual patient's expected relative benefit and thus inform shared decision making. Clinical guidelines should discuss age and gender as predictors of device benefits.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.