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Updated: May 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

Predictors of long-term benefit of cardiac resynchronization therapy in patients with right bundle branch block

Darryl P Leong1, Ulas Höke, Victoria Delgado

  • 1Department of Cardiology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.

European Heart Journal
|January 25, 2012
PubMed

Insights

Cardiac resynchronization therapy (CRT) in patients with right bundle branch block (RBBB) showed limited improvement. Left ventricular dyssynchrony and mitral regurgitation predict poor outcomes in RBBB patients receiving CRT.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Right bundle branch block (RBBB) is associated with poorer prognosis after cardiac resynchronization therapy (CRT) compared to left bundle branch block (LBBB).
  • Limited understanding exists regarding cardiac mechanics differences and predictors of favorable outcomes in RBBB patients undergoing CRT.

Purpose of the Study:

  • To characterize CRT recipients with RBBB versus LBBB.
  • To identify independent predictors of long-term outcomes in RBBB patients after CRT.

Main Methods:

  • Echocardiography assessed left ventricular (LV) size, function, and dyssynchrony (interventricular and LV) in 561 CRT recipients (89 RBBB, 472 LBBB) pre- and post-CRT.
  • Long-term follow-up data collected for all-cause mortality or heart failure hospitalization.

Main Results:

  • RBBB patients had higher rates of male gender, ischemic heart disease, and atrial fibrillation, with lower exercise capacity and less baseline dyssynchrony compared to LBBB patients.
  • RBBB patients demonstrated limited LV reverse remodeling six months post-CRT.
  • LV dyssynchrony and mitral regurgitation were identified as independent predictors of mortality or heart failure hospitalization in RBBB patients.

Conclusions:

  • Left ventricular dyssynchrony is a significant determinant of CRT outcomes in RBBB patients.
  • Identifying LV dyssynchrony may aid in selecting appropriate CRT candidates with RBBB.
Abstract

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