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Updated: Jun 30, 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

Hemodynamics and prognosis after primary cardiac resynchronization system implantation compared to "upgrade"

Herbert Nägele1, Julia Dodeck, Stefan Behrens

  • 1St. Adolfstift, Reinbek, Medical Department, Reinbek, Germany. herbert_naegele@yahoo.de

Pacing and Clinical Electrophysiology : PACE
|September 25, 2008
PubMed

Insights

Cardiac resynchronization therapy (CRT) benefits patients with left bundle branch block (LBBB) and right ventricular stimulation (RVS) similarly. Both groups showed comparable improvements in heart failure symptoms and long-term prognosis after CRT implantation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Left bundle branch block (LBBB) and right ventricular stimulation (RVS) can cause cardiac dyssynchrony and heart failure.
  • The comparative effectiveness of cardiac resynchronization therapy (CRT) for LBBB versus RVS is not well-established.

Purpose of the Study:

  • To compare the response to CRT in patients with primary LBBB implants versus those upgraded from RVS.
  • To evaluate long-term cardiac events and prognosis in these two patient groups.

Main Methods:

  • Retrospective analysis of 328 patients receiving CRT (1999-2006), comparing primary LBBB implants (n=221) with RVS upgrades (n=107).
  • Detailed subgroup analysis (n=105) assessed New York Heart Association class, quality of life, LVEF, and hemodynamic parameters at baseline and 1-year follow-up.

Main Results:

  • Baseline characteristics, including NYHA class and LVEF, were similar between LBBB and RVS groups, though RVS had more atrial fibrillation.
  • After 1 year, both groups showed comparable improvements in NYHA class, LVEF, and clinical parameters.
  • Median follow-up of ~2.4 years revealed no significant difference in long-term prognosis or cardiac event rates (5-year event rate: 53% vs 55%).

Conclusions:

  • Patients upgraded to CRT from RVS demonstrate similar baseline profiles and CRT response compared to primary LBBB implants.
  • CRT offers comparable long-term benefits and prognosis for both LBBB and RVS patient populations.
Abstract

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