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Updated: May 11, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Cardiac resynchronization therapy in CKD: a systematic review.

Neha Garg¹, George Thomas, Gregory Jackson

¹Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

Clinical Journal of the American Society of Nephrology : CJASN

|May 11, 2013

Summary

Cardiac resynchronization therapy (CRT) improves kidney and heart function in patients with chronic kidney disease (CKD). Further research is needed to confirm its effects on mortality in this population.

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Area of Science:

Cardiology
Nephrology
Medical Devices

Background:

Cardiac resynchronization therapy (CRT) offers benefits for heart failure patients.
This review focuses on CRT's impact on patients with chronic kidney disease (CKD), defined as estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m(2).

Purpose of the Study:

To systematically review the effects of CRT on patients with CKD.
To compare outcomes of CRT in CKD patients versus non-CKD patients.

Main Methods:

Searched MEDLINE, Scopus, and conference abstracts (1990-2012) for observational studies and RCTs.
Included studies comparing CKD patients with and without CRT, and CKD patients with CRT to non-CKD patients with CRT.
Extracted and pooled data on mortality, eGFR, and left ventricular ejection fraction using a random-effects model.

Main Results:

Eighteen studies (14 observational, 4 RCTs) were included.
CRT showed modest improvement in eGFR (mean difference 2.30 ml/min/1.73 m(2)) and significant improvement in left ventricular ejection fraction (mean difference 6.24%) in CKD patients.
Subgroup analysis of RCTs indicated lower rates of death or heart failure hospitalization with CRT in the CKD population. Survival outcomes varied between observational studies and RCTs when comparing CKD and non-CKD patients.

Conclusions:

CRT enhances both left ventricular and renal function in heart failure patients with CKD.
Further research is warranted to investigate CRT's effects on mortality in CKD patients, especially those with advanced kidney disease.