Australian Government - Department of Health

Medical Services Advisory Committee (MSAC)

1223 - Insertion, replacement, or removal of a cardiac resynchronisation therapy device capable of defibrillation (CRT-D) for mild, moderate or severe chronic heart failure (NYHA II, III or IV)

The documents on this page may not be accessible, should you require assistance accessing the information please contact the MSAC Secretariat.
Application Number1223
Application NameInsertion, replacement, or removal of a cardiac resynchronisation therapy device capable of defibrillation (CRT-D) for mild, moderate or severe chronic heart failure (NYHA II, III or IV).
Description of Medical ServiceCRT-D therapy requires the insertion of a cardiac resynchronisation therapy pulse generator and three leads. All three leads are inserted into the heart via the subclavian vein (or the cephalic or internal jugular vein in some cases), and the generator is positioned adjacent to the subclavian vein. The defibrillation lead is attached to the right ventricle and the pacing lead is attached to the right atrium. The third lead, which is required to coordinate ventricular contractions, is attached to the coronary venous system of the left ventricle. This lead also enters the heart via the subclavian vein, but it is then threaded through the coronary sinus and into the coronary vein.
Description of Medical ConditionPatients with heart failure not only suffer from shortness of breath with or without exercise, shortness of breath at night, fatigue and weakness, and possibly dizzy spells and palpitations, but they are also at increased risk of sudden cardiac arrest (SCA). For this reason, some patients are provided with an implantable cardioverter defibrillator (ICD), which in the event of a SCA may generate a shock to the heart thus restoring normal cardiac rhythm.
Clinical problems in patients suffering from heart failure, namely symptoms of shortness of breath and the risk of sudden death, led to the development of a device that combines the cardiac resynchronisation function with that of an ICD (i.e. a CRT-D).
Consultation ProtocolConsultation Protocol (PDF 858 KB)
Consultation Protocol (Word 499 KB)
Consultation Period 8 March 2013 – 25 March 2013
Final ProtocolFinal Protocol (PDF 1745 KB)
Final Protocol (Word 586 KB)
Final Protocol released 6 June 2013
ReportsAssessment Report (PDF 4695 KB)
Assessment Report (Word 32441 KB)
MSAC OutcomesFinal Public Summary Document (PDF 211 KB)
Final Public Summary Document (Word 138 KB)

Meetings for this Application

Meeting Type:Date:
PASC13 – 14 December 2012
ESC 10 -11 October 2013
MSAC 28 November 2013

Page currency, Latest update: 20 April, 2015