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Related Experiment Video

Updated: Jul 2, 2026

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

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

Impact of interventricular lead distance and the decrease in septal-to-lateral delay on response to cardiac

Sandra Buck¹, Alexander H Maass, Wybe Nieuwland

¹Department of Cardiology, Thoraxcenter, University Medical Center Groningen, University of Groningen, RB Groningen, The Netherlands.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology

|August 13, 2008

Summary

This summary is machine-generated.

Optimizing cardiac resynchronization therapy (CRT) success involves lead placement. A larger interlead distance and reduced septal-to-lateral delay predict positive CRT response in heart failure patients.

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

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Area of Science:

Cardiology
Electrophysiology
Heart Failure Management

Background:

Cardiac resynchronization therapy (CRT) is crucial for advanced chronic heart failure with electrical dyssynchrony.
Despite established criteria, 20-40% of patients do not respond to CRT, necessitating further optimization strategies.

Purpose of the Study:

To investigate how interlead distance and lead positioning influence CRT success.
To identify predictors of CRT response in patients with heart failure and dyssynchrony.

Main Methods:

Retrospective analysis of 174 CRT-implanted patients, defining response as a >=10% decrease in left ventricular end-systolic volume after 6 months.
Univariate and multivariate logistic regression analyses were used to identify predictors of CRT response.

Main Results:

Responders (55%) showed a significantly larger horizontal interlead distance (OR 2.8) and greater septal-to-lateral delay reduction (62 vs. 26 ms).
Other predictors included non-ischaemic cardiomyopathy, smaller LV end-diastolic diameter, ACE inhibitor use, and no tricuspid insufficiency.
A septal-to-lateral delay >60 ms was a strong predictor of response (OR 4.9).

Conclusions:

A larger interlead distance, often indicating posterior left ventricular lead placement, is associated with CRT response.
Diminishing intraventricular delay, specifically septal-to-lateral delay, is a key predictor of successful CRT outcomes.