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Updated: May 18, 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

Time from emerging heart failure symptoms to cardiac resynchronisation therapy: impact on clinical response

Frederik Hendrik Verbrugge1, Matthias Dupont, Jan Vercammen

  • 1Department of Cardiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, Genk 3600, Belgium.

Heart (British Cardiac Society)
|October 6, 2012
PubMed

Insights

Early cardiac resynchronisation therapy (CRT) improves survival in heart failure patients, likely due to better kidney function preservation. Reverse remodelling is unaffected by disease duration.

Area of Science:

  • Cardiology
  • Heart Failure Management
  • Medical Device Therapy

Background:

  • Cardiac resynchronisation therapy (CRT) is a treatment for heart failure.
  • The optimal timing for CRT implantation relative to heart failure symptom onset is unclear.
  • Previous studies have not fully explored the impact of disease duration on CRT outcomes.

Purpose of the Study:

  • To determine if the time from heart failure symptom onset to CRT implantation influences reverse remodelling.
  • To assess the effect of implantation timing on clinical outcomes in CRT patients.
  • To investigate the role of renal function in the relationship between implantation timing and outcomes.

Main Methods:

  • A cohort study of 172 consecutive CRT patients implanted between October 2008 and April 2011.
  • Patients were stratified into tertiles based on the time from heart failure symptom onset to implantation.
  • Outcomes assessed included changes in left ventricular dimensions, New York Heart Association (NYHA) functional class, and freedom from all-cause mortality or heart failure admission.

Main Results:

  • Earlier implantation was associated with better baseline renal function (estimated glomerular filtration rate).
  • Reverse remodelling (left ventricular size reduction, NYHA class improvement) was similar across all tertiles.
  • Patients receiving early CRT showed improved freedom from mortality or heart failure admission (p=0.042), particularly those with preserved renal function (p=0.794).
  • Later implantation correlated with a higher incidence of death from progressive heart failure.

Conclusions:

  • The duration of heart failure does not appear to affect reverse left ventricular remodelling following CRT.
  • Earlier CRT implantation is associated with better clinical outcomes, likely linked to better preservation of renal function.
  • These findings suggest that timely CRT intervention is crucial for optimizing patient prognosis in heart failure.
Abstract

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