Related Experiment Video
Updated: Jun 14, 2026
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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
Characterization of super-response to cardiac resynchronization therapy
John Rickard1, Dharam J Kumbhani, Zoran Popovic
1Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA. rickarj2@ccf.org
Heart Rhythm
|April 13, 2010
Summary
Patients with left bundle branch block who receive cardiac resynchronization therapy (CRT) are more likely to be super-responders, experiencing significantly better long-term survival outcomes.
Area of Science:
- Cardiology
- Heart Failure Management
- Cardiac Electrophysiology
Background:
- Cardiac resynchronization therapy (CRT) offers modest benefits for most patients with chronic systolic heart failure.
- A subset of patients, termed 'super-responders,' exhibit dramatic improvements with CRT, but their characteristics are not well-defined.
Purpose of the Study:
- To identify baseline clinical characteristics associated with super-response to CRT.
- To evaluate the survival benefit in CRT super-responders compared to non-super-responders.
Main Methods:
- Retrospective analysis of 233 patients with systolic heart failure receiving CRT.
- Defined super-responders as those with a > or = 20% absolute increase in left ventricular ejection fraction (LVEF).
- Utilized multivariate analysis to identify predictors of super-response and assessed mortality.
Main Results:
- 13.7% of patients (32/233) were identified as super-responders.
- Left bundle branch block (LBBB) was the only significant predictor of super-response in multivariate analysis.
- Super-responders demonstrated significantly lower mortality (9.4% vs. 43.2%) over a mean follow-up of 5.5 years.
Conclusions:
- Baseline left bundle branch block is a strong predictor of super-response to cardiac resynchronization therapy.
- Super-responders to CRT experience substantially improved long-term survival compared to non-super-responders.
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