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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

Sustained benefit of cardiac resynchronization therapy

Peter Paul H M Delnoy1, Jan Paul Ottervanger, Henk Oude Luttikhuis

  • 1Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands. v.r.c.derks@isala.nl

Journal of Cardiovascular Electrophysiology
|February 8, 2007
PubMed

Insights

Cardiac resynchronization therapy (CRT) shows sustained echocardiographic improvements in heart failure patients over two years. Early CRT response, indicated by LVEF increase, predicts better long-term survival.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Limited long-term echocardiographic data exists for cardiac resynchronization therapy (CRT) from real-world patient populations.
  • Most existing CRT data comes from highly selected patient cohorts in clinical trials.

Purpose of the Study:

  • To assess long-term echocardiographic remodeling following CRT in a general patient population.
  • To evaluate the sustained effects of CRT on heart function and structure over two years.

Main Methods:

  • A biventricular pacemaker was implanted in 130 advanced heart failure patients.
  • Two-year echocardiographic follow-up was conducted.
  • Patient data included baseline characteristics, echocardiographic parameters, and mortality.

Main Results:

  • Echocardiographic response (≥5% LVEF improvement) was observed in 69% at 3 months, increasing to 91% by 2 years in survivors.
  • Left ventricular ejection fraction (LVEF) improved significantly from 22% at baseline to 39.7% at 2 years.
  • Reverse remodeling (≥10% reduction in LV end-systolic volume) was sustained, reaching 91.7% by 2 years.
  • Early LVEF improvement after 3 months correlated with better long-term survival (P=0.04).
  • Mortality was higher in males, patients with elevated NT-proBNP, renal dysfunction, or left atrial dilatation.

Conclusions:

  • Cardiac resynchronization therapy leads to sustained left ventricular reverse remodeling and improved echocardiographic measures over two years.
  • An increase in LVEF of 5% or more within 3 months of CRT implantation is associated with improved long-term survival.
Abstract

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