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Updated: Jun 17, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Cardiac resynchronization therapy in non-left bundle branch block morphologies.

John Rickard1, Dharam J Kumbhani, Eiran Z Gorodeski

  • 1Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195, USA. rickarj2@ccf.org

Pacing and Clinical Electrophysiology : PACE
|December 23, 2009
PubMed
Summary
This summary is machine-generated.

Cardiac resynchronization therapy (CRT) shows no survival difference across left bundle branch block (LBBB), right bundle branch block (RBBB), or intraventricular conduction delay (IVCD) groups. However, LBBB patients experience greater benefits in cardiac remodeling and symptoms.

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Published on: January 31, 2019

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Cardiac resynchronization therapy (CRT) improves outcomes in select systolic heart failure patients.
  • Limited data exists on CRT response in patients with right bundle branch block (RBBB) or non-specific intraventricular conduction delay (IVCD) compared to left bundle branch block (LBBB).

Purpose of the Study:

  • To compare the long-term survival and clinical response to CRT in patients with LBBB, RBBB, and IVCD.
  • To evaluate the impact of baseline QRS morphology on CRT efficacy.

Main Methods:

  • 542 patients undergoing CRT implantation were categorized by pre-implantation electrocardiogram: LBBB, RBBB, or IVCD.
  • Exclusion criteria included narrow QRS or paced ventricular rhythm.
  • Primary endpoint was long-term survival; secondary endpoints included changes in ejection fraction (EF), cardiac dimensions, mitral regurgitation, and NYHA functional class.

Main Results:

  • 335 patients met inclusion criteria (204 LBBB, 38 RBBB, 93 IVCD).
  • No significant difference in 3-year mortality was observed among the LBBB, RBBB, and IVCD groups.
  • Patients with LBBB demonstrated superior improvements in echocardiographic parameters and NYHA functional class compared to RBBB and IVCD groups.

Conclusions:

  • Baseline QRS morphology (LBBB, RBBB, IVCD) does not influence 3-year survival following CRT.
  • Patients with RBBB and IVCD experience less favorable reverse cardiac remodeling and symptomatic improvement from CRT compared to LBBB patients.