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Updated: Feb 25, 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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Impact of an Age-Adjusted Co-morbidity Index on Survival of Patients With Heart Failure Implanted With Cardiac

Adam Ioannou1, Nikolaos Papageorgiou2, Harry Barber3

  • 1St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; University College of London Hospitals NHS Trust, London, United Kingdom.

The American Journal of Cardiology
|August 9, 2017
PubMed

Insights

Age and co-morbidities significantly impact outcomes for patients receiving cardiac resynchronization therapy (CRT). The Charlson Age-Co-morbidity Index (CACI) best predicts survival, helping to identify suitable candidates for CRT.

Area of Science:

  • Cardiology
  • Geriatrics
  • Medical Statistics

Background:

  • Age is a known negative prognostic factor in heart failure.
  • Cardiac resynchronization therapy (CRT) is a treatment option for heart failure.
  • The combined impact of age and non-cardiac comorbidities on CRT outcomes requires further investigation.

Purpose of the Study:

  • To evaluate how age and non-cardiac comorbidities affect the outcomes of patients undergoing CRT.
  • To determine whether age or comorbidities are stronger predictors of survival after CRT.
  • To assess the utility of the Charlson Age-Co-morbidity Index (CACI) in predicting CRT outcomes.

Main Methods:

  • A retrospective analysis of 697 consecutive CRT implants over 12 years.
  • Assessment of patient comorbidities using the Charlson Co-morbidity Index (CCI) and CACI.
  • Multivariate Cox regression analysis to identify predictors of survival free from heart transplantation.

Main Results:

  • The Charlson Age-Co-morbidity Index (CACI) was the most significant predictor of all-cause mortality, outperforming age and CCI alone.
  • Independent predictors of mortality or heart transplantation included female gender, estimated glomerular filtration rate, left ventricular ejection fraction, NYHA class, left bundle branch block, and CACI tertile.
  • Higher CACI tertiles were associated with less frequent inappropriate therapies.

Conclusions:

  • Patient comorbidity profile, adjusted for age, significantly influences mortality post-CRT implantation.
  • The CACI is a valuable tool for discriminating mortality risk in CRT patients.
  • Utilizing the CACI may refine selection criteria for CRT, identifying patients most likely to benefit.

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