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Updated: Mar 13, 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

Published on: December 11, 2017

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Morbidity and mortality with cardiac resynchronization therapy with pacing vs. with defibrillation in octogenarian

Avishag Laish-Farkash1, Sharon Bruoha1, Amos Katz1

  • 1Electrophysiology and Pacing Unit, Department of Cardiology, Barzilai University Medical Center, Ashkelon and Faculty of Health Sciences, Ben-Gurion University of the Negev, 2 Hahistadrut Street, Ashkelon 78278, Israel.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|October 14, 2016
PubMed

Insights

Cardiac resynchronization therapy without a defibrillator (CRT-P) offers similar survival and morbidity benefits as CRT with a defibrillator (CRT-D) in octogenarians. This suggests CRT-P may be a suitable alternative for older patients eligible for CRT.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Medical Devices

Background:

  • Cardiac resynchronization therapy (CRT) improves outcomes in heart failure.
  • CRT with a defibrillator (CRT-D) is costly and carries risks like inappropriate shocks.
  • Implantable cardioverter defibrillator (ICD) benefits may be reduced in older adults.

Purpose of the Study:

  • To compare the efficacy of CRT without a defibrillator (CRT-P) versus CRT with a defibrillator (CRT-D) in octogenarians.
  • To determine if CRT-P offers similar morbidity and mortality benefits as CRT-D in this age group.
  • To evaluate the suitability of CRT-P as an alternative to CRT-D for elderly patients.

Main Methods:

  • Retrospective comparison of octogenarian patients undergoing CRT-P (n=142) versus CRT-D (n=104) for primary prevention.
  • Analysis of morbidity and mortality outcomes, including all-cause mortality and heart failure events.
  • Kaplan-Meier survival analysis and Cox proportional hazard models with competing risks were used.

Main Results:

  • No significant difference in 5-year all-cause mortality between CRT-P (43%) and CRT-D (57%) groups (P=0.37).
  • Similar rates of the combined endpoint of heart failure or death observed in both groups (46% vs. 60%, P=0.55).
  • No significant difference in cardiac re-hospitalizations between CRT-P and CRT-D recipients (P=0.37).

Conclusions:

  • CRT-P therapy is associated with comparable morbidity and mortality outcomes to CRT-D in octogenarians with systolic heart failure.
  • CRT-P may be a viable and potentially less burdensome alternative to CRT-D for elderly patients.
  • These findings support the consideration of CRT-P in octogenarians eligible for CRT.
Abstract

Keywords:
Cardiac resynchronization therapyMorbidityMortalityOctogenarians

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