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Updated: Apr 12, 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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Does Age Influence Cardiac Resynchronization Therapy Use and Outcome?

Paul A Heidenreich1, Vivian Tsai2, Haikun Bao3

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JACC. Heart Failure
|May 19, 2015
PubMed
Summary

Older patients receiving cardiac resynchronization therapy with defibrillator (CRT-D) showed improved survival rates compared to those with an implantable cardioverter-defibrillator (ICD) alone. This benefit was consistent across all age groups, highlighting CRT-D

Keywords:
cardiac resynchronization therapyelderlyheart failure

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Area of Science:

  • Cardiology
  • Medical Devices
  • Geriatric Medicine

Background:

  • Many patients receiving cardiac resynchronization therapy with defibrillator (CRT-D) are older than those in clinical trials.
  • Real-world CRT-D patient populations differ from trial populations, necessitating studies on older adults.

Purpose of the Study:

  • To describe the utilization of CRT-D in older patients.
  • To evaluate the association between CRT-D implantation and survival outcomes in elderly individuals.

Main Methods:

  • Utilized the National Cardiovascular Disease Registry (NCDR) ICD registry (2006-2009).
  • Identified patients meeting clinical trial criteria for CRT (LVEF ≤35%, QRS ≥120 ms, NYHA class III-IV).
  • Linked NCDR data with the Social Security Death Index to determine all-cause mortality.

Main Results:

  • CRT-D receipt was associated with significantly better 1-year (82.1% vs. 77.1%) and 4-year (54.0% vs. 46.2%) survival compared to ICD alone (p < 0.001).
  • The survival benefit of CRT-D was consistent across different age groups (p=0.86 for interaction).
  • Over 80% of eligible older patients received CRT-D, with 6.4% aged 85+.

Conclusions:

  • CRT-D is widely used in older patients meeting trial criteria for implantation.
  • Older patients undergoing ICD implantation have high mortality, but CRT-D is associated with lower mortality.
  • The survival advantage of CRT-D in older populations supports its use in this demographic.