Efficacy of Implantable Cardioconverter Defibrillator or Cardiac Resynchronization Therapy Compared With Combined Therapy in Survival of Patients With Heart Failure: A Meta-Analysis

The aim of this meta-analysis was to compare the efficacy of implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy (CRT) monotherapies with CRT–ICD combined therapy. Databases were searched to identify studies that compared CRT or ICD alone with CRT–ICD combined therapy in patients with heart failure. The primary outcome was rate of death for any cause, and secondary outcomes included rate of death or hospitalization due to heart failure or any cause. Nine studies with 7679 patients were included. Combined data of ICD and CRT monotherapies found that there was a higher risk of all-cause death (odds ratio [OR] 1.348, P < 0.001) and death or hospitalization from heart failure (OR 1.368, P < 0.001) with monotherapy compared with CRT–ICD combined therapy. No significant difference was observed between mono and combined therapy groups for risk of death or hospitalization from any cause (OR 1.292, P = 0.083). Compared with ICD or CRT monotherapy, CRT–ICD therapy had favorable outcomes regarding all-cause death and the risk of hospitalization or death due to heart failure.