BOSTON — A medical cynic might say that expanding waistlines lead to expanding device indications, but the issue of whether cardiac resynchronization therapy (CRT) is appropriate for patients with right bundle branch blockage (RBBB) surfaced at the annual meeting of the Heart Rhythm Society (HRS; Washington). Two cardiologists made their cases in support of and in opposition to the use of CRT for RBBB and other non-LBBB syndromes, and an informal survey conducted before and after the face-off suggested that cardiologists who are opposed to an expanded indication can be swayed by existing evidence.
BOSTON — Makers of remote cardiology monitoring systems received a dose of good news with the announcement by the Heart Rhythm Society (HRS; Washington) that remote monitoring should be the standard of care for patients with device implants. The news is another in a series of positives for the device category, given that recent estimates of the market for remote monitoring and cardiac rhythm management systems are expected to jointly reach more than $23 billion in 2017.
Much to the chagrin of device makers, a recent government analysis on the evidence behind the use of catheter ablation to treat atrial fibrillation did not offer a glowing recommendation of this modality. The report said, "there was insufficient evidence to draw conclusions regarding the efficacy, effectiveness and safety" of this procedure for Medicare beneficiaries, although the procedure is already covered. However, the Centers for Medicare & Medicaid Services can revert to clinical trial coverage thanks to a recent change in its coverage with evidence development policy.