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Updated: Apr 21, 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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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Effect of cardiac resynchronization therapy on ventricular repolarization: a meta-analysis

Xu Duan1, Wei Gao

  • 1Department of Cardiology, The First People's Hospital of Hangzhou; Hangzhou-China. duanxu410@yahoo.com.cn.

Anatolian Journal of Cardiology
|October 22, 2014
PubMed

Insights

Cardiac resynchronization therapy (CRT) does not worsen ventricular repolarization with biventricular pacing. However, left ventricular pacing may prolong the Tp-e interval, indicating a potential proarrhythmic effect.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Cardiac resynchronization therapy (CRT) is used to treat heart failure.
  • Previous studies on CRT's effect on ventricular repolarization yielded inconsistent results.
  • Concerns exist regarding a potential proarrhythmic effect of CRT.

Purpose of the Study:

  • To determine the effect of CRT on ventricular repolarization.
  • To clarify the impact of biventricular (BV) and left ventricular (LV) pacing on repolarization parameters.

Main Methods:

  • A meta-analysis of 14 studies was performed.
  • Investigated the effect of CRT on QT interval (QT), JT interval (JT), QT dispersion (QTD), and Tp-e interval.
  • Compared pacing modes (BV, LV) with intrinsic ventricular rhythm.

Main Results:

  • Biventricular pacing showed no significant difference in QT, JT, or Tp-e compared to intrinsic rhythm.
  • QT dispersion (QTD) was lower with BV pacing, though significance was ambiguous (p=0.05).
  • Left ventricular pacing significantly prolonged the Tp-e interval (p=0.03) compared to intrinsic rhythm.

Conclusions:

  • Biventricular pacing in CRT does not appear to have a proarrhythmic effect on ventricular repolarization.
  • Left ventricular pacing may prolong the Tp-e interval, suggesting a potential proarrhythmic risk.
  • Further research is needed to fully understand the repolarization effects of different CRT pacing strategies.
Abstract

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