Related Experiment Video
Updated: May 25, 2026
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
Cardiac resynchronization therapy: expanding clinical indications and refining patient selection
Pablo B Nery1, Arieh Keren, David H Birnie
1University of Ottawa Heart Institute, Ottawa, Canada. Pnery@ottawa-heart.ca
Current Opinion in Cardiology
|January 12, 2012
Summary
Cardiac resynchronization therapy (CRT) improves outcomes for heart failure patients. Optimal patient selection is key, especially for those with NYHA class II-III and atrial fibrillation, while CRT is not recommended for right bundle branch block.
Area of Science:
- Cardiology
- Medical Technology
- Heart Failure Management
Background:
- Cardiac resynchronization therapy (CRT) is established for heart failure (HF) treatment.
- A significant portion of patients do not achieve optimal response to CRT.
- Effective patient selection is crucial for maximizing CRT benefits.
Purpose of the Study:
- To review current clinical evidence on patient selection for CRT.
- To address key questions regarding optimal candidates for CRT.
- To guide clinicians in improving CRT outcomes.
Main Methods:
- Review of recent large randomized trials.
- Analysis of observational studies and meta-analyses.
- Synthesis of data on specific patient subgroups (NYHA classes, atrial fibrillation, RBBB).
Main Results:
- CRT demonstrates reduced morbidity and mortality in NYHA class II HF.
- Potential benefit of CRT in NYHA III HF with atrial fibrillation, recommending AV node ablation for optimal pacing.
- Current data do not support CRT use in patients with baseline right bundle branch block (RBBB).
Conclusions:
- Careful selection of CRT candidates is vital for improved patient outcomes.
- Optimizing biventricular pacing is essential, particularly in patients with atrial fibrillation.
- Evidence guides CRT use in specific HF populations, highlighting limitations in RBBB.
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