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Updated: Jun 4, 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
Cardiac resynchronization therapy: a meta-analysis of randomized controlled trials
George Wells1, Ratika Parkash, Jeffrey S Healey
1University of Ottawa Heart Institute, Ottawa, Ont. gawells@ottawaheart.ca
Summary
Adding cardiac resynchronization therapy (CRT) to optimal medical therapy or defibrillator therapy significantly reduces mortality in heart failure patients. This meta-analysis confirms CRT
Area of Science:
- Cardiology
- Medical Devices
- Clinical Trials
Background:
- Previous studies on CRT in mild to moderate heart failure with defibrillators did not consistently show mortality benefits.
- The RAFT trial provided new evidence, prompting a comprehensive meta-analysis.
Purpose of the Study:
- To determine the effect of CRT, with or without an implantable defibrillator, on mortality in heart failure patients.
- To synthesize evidence from existing randomized trials, including the RAFT trial.
Main Methods:
- A meta-analysis was conducted, searching electronic databases for relevant randomized trials.
- Studies included patients with heart failure on optimal medical therapy, comparing CRT alone or CRT with an implantable defibrillator against control groups.
- The primary outcome was mortality, with optimum information size analysis used to assess the need for further trials.
Main Results:
- The meta-analysis included 12 studies with 7538 patients.
- CRT plus optimal medical therapy significantly reduced mortality (RR 0.73).
- CRT plus an implantable defibrillator also significantly reduced mortality (RR 0.83), particularly in NYHA class I/II patients.
Conclusions:
- The cumulative evidence now conclusively shows that CRT significantly reduces mortality in heart failure patients.
- Adding CRT to optimal medical therapy or defibrillator therapy is a proven mortality-reducing strategy.
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