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Updated: Feb 10, 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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Optimal left ventricular lead placement for cardiac resynchronization therapy in postmyocardial infarction patients

Carmine Muto1, Francesco Solimene2, Vincenzo Russo3

  • 1Cardiologia, Ospedale Santa Maria della Pietà, Nola, Napoli, Italy.

Future Cardiology
|May 17, 2018
PubMed

Insights

Optimal cardiac resynchronization therapy (CRT) lead placement improves outcomes in heart failure patients post-myocardial infarction (MI). This study shows improved ejection fraction and reverse remodeling with CRT, especially with ideal LV lead positioning.

Area of Science:

  • Cardiology
  • Heart Failure Management
  • Medical Device Technology

Background:

  • Post-myocardial infarction (MI) heart failure presents significant clinical challenges.
  • Cardiac resynchronization therapy (CRT) is a treatment option for eligible heart failure patients.
  • Optimizing CRT device placement may enhance therapeutic efficacy.

Purpose of the Study:

  • To assess 12-month clinical and echocardiographic outcomes of CRT in post-MI heart failure.
  • To investigate the impact of left ventricular (LV) lead positioning relative to the ischemic area on CRT response.

Main Methods:

  • A cohort of 100 patients with post-MI heart failure received CRT devices.
  • Patients were stratified into groups based on MI location and LV lead placement (downstream of ischemic area).
  • Echocardiographic parameters and CRT response rates were evaluated at 12-month follow-up.

Main Results:

  • Significant improvement in LV ejection fraction (28% to 35%, p < 0.001) and reverse remodeling (LV end-systolic volume reduction, p = 0.001).
  • 53% of patients achieved echocardiographic response.
  • Optimal LV lead placement resulted in 67% CRT responders versus 38% in others (p = 0.01).

Conclusions:

  • Optimal LV lead positioning is a feasible strategy to increase CRT response rates in post-MI heart failure.
  • CRT can significantly improve cardiac function and reverse remodeling in this patient population.
  • Targeted lead placement enhances the effectiveness of CRT for heart failure management.
Abstract

Keywords:
CRT respondersLV remodelingcardiac resynchronization therapyventricular mechanical activation

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