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

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Relationship between pre-implant ejection fraction and outcome after cardiac resynchronization therapy in symptomatic

Andreas Schuchert, Carmine Muto, Themistoklis Maounis

    Acta Cardiologica
    |September 4, 2014
    PubMed

    Insights

    Patients with severe left-ventricular ejection fraction (LVEF) impairment showed greater LVEF improvement after cardiac resynchronization therapy (CRT). Pre-implant LVEF did not predict long-term outcomes in symptomatic CRT patients.

    Area of Science:

    • Cardiology
    • Heart Failure Research
    • Medical Device Technology

    Background:

    • Left-ventricular ejection fraction (LVEF) is a key predictor of morbidity and mortality in heart failure.
    • Cardiac resynchronization therapy (CRT) is used for advanced heart failure patients.

    Purpose of the Study:

    • To evaluate the association between pre-implant LVEF and patient outcomes following CRT.
    • To determine if baseline LVEF influences the effectiveness of CRT in advanced heart failure.

    Main Methods:

    • Analysis of two-year follow-up data from 366 NYHA class III/IV heart failure patients in the MASCOT study.
    • Patients received CRT with a class I indication.
    • Pre-implant LVEF was stratified into three tertiles for analysis.

    Main Results:

    • Patients in the lowest LVEF tertile (<22%) showed a significantly greater improvement in LVEF post-CRT compared to those with higher baseline LVEF.
    • NYHA class and quality of life scores improved similarly across all LVEF groups.
    • No significant differences were observed in all-cause mortality, cardiac death, or hospitalizations among the groups.

    Conclusions:

    • Symptomatic heart failure patients with severely impaired LVEF experience greater LVEF improvement with CRT.
    • Pre-implant LVEF is not predictive of long-term cardiovascular morbidity and mortality in symptomatic patients receiving CRT.
    • The enhanced LVEF improvement in severely impaired patients may explain the lack of correlation with long-term outcomes.
    Abstract

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