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Updated: Aug 3, 2026
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
Long-term follow-up of cardiac resynchronization therapy in patients with end-stage heart failure
Sander G Molhoek1, Jeroen J Bax, Gabe B Bleeker
1Department of Cardiology, Leiden University Medical Center, The Netherlands.
Insights
Cardiac resynchronization therapy (CRT) offers sustained benefits for heart failure patients, maintaining improved function and reduced hospitalizations up to 3 years. Identifying responders pre-implantation may further enhance long-term survival rates.
Area of Science:
- Cardiology
- Heart Failure Management
- Medical Devices
Background:
- Cardiac resynchronization therapy (CRT) is a promising treatment for end-stage heart failure.
- Long-term efficacy and patient prognosis following CRT require further investigation.
Purpose of the Study:
- To assess the sustained benefits of CRT in a large cohort of heart failure patients.
- To evaluate the long-term prognosis of CRT responders versus nonresponders.
Main Methods:
- 125 patients with advanced heart failure received biventricular devices.
- Clinical parameters, quality of life, and QRS duration were assessed at baseline and 6 months.
- Follow-up extended to 3 years, with patients categorized as responders or nonresponders based on NYHA class improvement.
Main Results:
- Significant improvements in all clinical parameters were observed at 6-month follow-up.
- Hospitalizations for heart failure decreased significantly post-CRT (3.8 days/year to 0.7 days/year).
- 3-year survival rates were 85%, with responders showing significantly better survival (93%) than nonresponders (73%).
Conclusions:
- The functional and symptomatic improvements from CRT are maintained long-term (up to 3 years).
- CRT significantly reduces hospitalization rates, with sustained benefits over time.
- Pre-implantation identification of responders can potentially lead to improved long-term survival outcomes.
Unlabelled:
Long-term follow-up of cardiac resynchronization therapy.
Introduction:
Cardiac resynchronization therapy (CRT) has been introduced to treat patients with end-stage heart failure, and results of this technique are promising. The aim of our study was to assess the sustained benefit of CRT in a large patient cohort with end-stage heart failure at long-term follow-up. In addition, the prognosis of responders and nonresponders was evaluated.
Methods And Results:
125 patients with end-stage heart failure, NYHA class III or IV, LVEF<35%, QRS duration>120 msec and left bundle branch block morphology received a biventricular device. At baseline and 6 months after implantation the following parameters were evaluated: NYHA class, Minnesota Quality of life score, QRS duration on surface ECG, 6-minute walking distance and LVEF. Follow-up was obtained up to 3 years. After 6 months, patients were divided in clinical responders and nonresponders according to improvement in NYHA class. All clinical parameters improved significantly at 6-month follow-up. Hospitalization for heart failure was 3.8+/-4.9 days/year before and 0.7+/-1.6 days/year after CRT. Survival at 1-, 2-, and 3-year follow-up was 93%, 88%, and 85%, respectively. Responders (78%) showed a significantly better survival than nonresponders at 2- and 3-year follow-up (96% and 93% for responders versus 81% and 73% for nonresponders, P<0.05).
Conclusion:
The improvement in functional status and symptoms after CRT is maintained at long-term follow-up (up to 3 years). The clinical improvement was associated with a significant reduction in hospitalization rate which was also maintained over the years. Preimplantation selection of responders may result in even better long-term survival.
