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Related Experiment Video

Updated: Feb 6, 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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Cardiac resynchronisation therapy: current benefits and pitfalls.

Annamaria Kosztin, Andras Mihaly Boros, Laszlo Geller

  • 1Semmelweis University, Heart and Vascular Center, Budapest, Hungary. merkely.study@gmail.com.

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PubMed
Summary
This summary is machine-generated.

Cardiac resynchronisation therapy (CRT) improves outcomes, but patient selection needs refinement. Optimal LV lead placement and reconsidering ejection fraction criteria enhance CRT effectiveness for heart failure patients.

Keywords:
QRS morphologycardiac resynchronization therapycurrent indicationspredictors in CRTupgrade

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Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Cardiac resynchronisation therapy (CRT) is proven to reduce mortality and improve heart failure symptoms and quality of life.
  • However, a significant number of patients do not respond to CRT, necessitating improved patient selection criteria.
  • Current guidelines recommend evaluating QRS morphology and width, alongside left ventricular ejection fraction (LVEF), for CRT candidacy.

Purpose of the Study:

  • To review current evidence on optimizing patient selection for CRT.
  • To discuss the prognostic value of QRS morphology versus QRS width.
  • To evaluate the role of LVEF and LV lead placement in CRT outcomes.

Main Methods:

  • Review of multicentre randomised trials and recent clinical data on CRT.
  • Analysis of factors influencing CRT response, including QRS characteristics, LVEF, and lead positioning.
  • Discussion of unresolved issues in CRT device selection and upgrades.

Main Results:

  • QRS morphology appears more predictive of CRT outcomes than QRS width alone.
  • LVEF criteria for CRT candidacy may be too stringent, as patients with LVEF > 35% can benefit.
  • LV lead implantation in the lateral or posterior coronary sinus branches is associated with better long-term clinical outcomes.

Conclusions:

  • Refining patient selection for CRT by prioritizing QRS morphology and reconsidering LVEF thresholds can improve treatment efficacy.
  • Optimal LV lead positioning is critical for achieving positive long-term outcomes in CRT patients.
  • Further research is needed to clarify device type selection and upgrade strategies for CRT.