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Updated: Aug 11, 2026

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

Clinical outcomes after cardiac resynchronization therapy: importance of left ventricular diastolic function and

Alan D Waggoner1, Aleksandr Rovner, Lisa de las Fuentes

  • 1Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri 63110, USA. waggonea@msnotes.wustl.edu

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|February 28, 2006
PubMed

Insights

Cardiac resynchronization therapy (CRT) improves systolic function but not diastolic function in patients with ischemic cardiomyopathy. Nonischemic cardiomyopathy patients show improved diastolic function and better clinical outcomes after CRT.

Area of Science:

  • Cardiology
  • Heart Failure Management
  • Echocardiography

Background:

  • Cardiac resynchronization therapy (CRT) benefits patients with severe systolic heart failure.
  • The impact of CRT on left ventricular (LV) diastolic function and clinical outcomes based on cardiomyopathy (CM) cause (ischemic vs. nonischemic) is not well understood.

Purpose of the Study:

  • To investigate whether the cause of cardiomyopathy influences the effects of CRT on LV diastolic function and clinical outcomes.

Main Methods:

  • Echocardiography was used to assess LV systolic and diastolic function in 57 heart failure patients before and after CRT.
  • Patients were categorized into ischemic CM (n=19) and nonischemic CM (n=38) groups.
  • Long-term clinical outcomes included heart failure hospitalizations, transplantation, and cardiac death.

Main Results:

  • Both groups showed improved LV ejection fraction and reduced end-systolic volumes after CRT.
  • Significant improvements in LV diastolic function were observed exclusively in the nonischemic CM group.
  • The ischemic CM group experienced a higher rate of clinical events (53% vs. 26%) compared to the nonischemic CM group.
  • Doppler-derived LV filling pressures predicted clinical outcomes.

Conclusions:

  • Ischemic cardiomyopathy patients undergoing CRT show no improvement in LV diastolic function, despite enhanced LV systolic performance.
  • Doppler-derived LV filling indices may serve as crucial predictors of long-term clinical outcomes following CRT.
Abstract

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