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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Benefits of cardiac resynchronization therapy in outpatients with indicators for heart transplantation

Jeffrey M Greenberg1, Angel R Leon, Wendy M Book

  • 1Center for Heart Failure Therapy, Emory University School of Medicine, 1364 Clifton Road NE, Suite 508, Atlanta, GA 30322, USA.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|October 11, 2003
PubMed

Insights

Cardiac resynchronization therapy (CRT) significantly improves heart function and reduces transplant candidacy in advanced congestive heart failure (CHF) patients. Most patients no longer required transplantation after CRT treatment.

Area of Science:

  • Cardiology
  • Heart Failure Management
  • Medical Devices

Background:

  • Rising heart transplant waiting lists highlight the need for advanced congestive heart failure (CHF) treatments.
  • Cardiac resynchronization therapy (CRT) is an FDA-approved treatment for advanced CHF.
  • Data on CRT's efficacy in potential heart transplant candidates are currently lacking.

Purpose of the Study:

  • To evaluate the impact of CRT on patients meeting criteria for heart transplantation.
  • To assess changes in ventricular function, oxygen uptake, and NYHA class post-CRT therapy.

Main Methods:

  • Retrospective review of 34 patients with advanced CHF meeting heart transplant criteria.
  • Comparison of ventricular function, maximal oxygen uptake (VO2), and New York Heart Association (NYHA) class at baseline and 6 months after CRT initiation.

Main Results:

  • CRT significantly reduced QRS duration (178 to 143 ms) and improved NYHA class (3.1 to 1.8).
  • Ejection fraction (EF) increased from 18.4% to 25.1%, and maximal VO2 improved from 11.9 to 15.3 ml/kg/min.
  • Only 2 of 34 patients remained transplant candidates after 6 months of CRT.

Conclusions:

  • CRT enhances ventricular function, oxygen uptake, and functional class in CHF patients with prolonged QRS duration (>130 ms).
  • CRT may prevent or delay the need for heart transplantation in eligible patients.
  • Evaluation for CRT is recommended for outpatients with chronic CHF and widened QRS before cardiac transplantation listing.
Abstract

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