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Updated: Jun 25, 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

Hemodynamic benefit of multiple programmable pacing configurations in patients with biventricular pacemakers

Ramprakash Balasundaram1, Hygriv B Rao, C Sridevi

  • 1CARE Hospitals and CARE Foundation, Hyderabad, India.

Pacing and Clinical Electrophysiology : PACE
|March 3, 2009
PubMed

Insights

Optimizing left ventricular stimulation (LVS) configurations in cardiac resynchronization therapy (CRT) can significantly improve hemodynamic function, including cardiac output and mitral regurgitation, in heart failure patients.

Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Cardiac resynchronization therapy (CRT) is a key treatment for heart failure.
  • A significant portion of patients (one-third) do not respond optimally to CRT.
  • Left ventricular stimulation (LVS) configurations are explored to enhance CRT efficacy and manage complications like diaphragmatic capture.

Purpose of the Study:

  • To evaluate the hemodynamic effects of varying LVS configurations in patients receiving CRT.
  • To identify optimal LVS settings for improved cardiac function.

Main Methods:

  • The study included patients with CRT systems allowing multiple LVS configurations.
  • Hemodynamic parameters including cardiac output (CO), myocardial performance index (MPI), and mitral regurgitation (MR) were measured.
  • Parameters were assessed across different LVS configurations, optimizing delays and comparing best vs. worst outcomes based on CO.

Main Results:

  • Significant changes in CO and MPI were observed across different LVS configurations.
  • Fifty percent of patients demonstrated a > or =20% difference in CO between optimal and suboptimal LVS settings.
  • Mitral regurgitation severity improved by at least one grade in 64% of patients (9 out of 14).

Conclusions:

  • Left ventricular stimulation configuration is a critical factor influencing hemodynamic performance in CRT recipients.
  • Tailoring LVS settings can lead to substantial improvements in cardiac output and mitral regurgitation.
  • Further research into LVS optimization may enhance CRT outcomes for heart failure patients.
Abstract

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