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Updated: Nov 12, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

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

10.7K

Upgrading to cardiac resynchronisation therapy: Concordance of real-world experience with clinical guidelines

Laura Tan1, Sashiananthan Ganesananthan2, Hani Huzaien1

  • 1Department of Cardiology, University Hospital of Wales, Cardiff, Wales, United Kingdom.

International Journal of Cardiology. Heart & Vasculature
|March 22, 2021
PubMed

Insights

Revision to cardiac resynchronisation therapy (CRT) improves heart failure (HF) symptoms. Non-ischaemic cardiomyopathy, sinus rhythm, and high RV pacing predict better left ventricular ejection fraction (LVEF) improvement after CRT revision.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Revision to cardiac resynchronisation therapy (CRT) can enhance outcomes in patients with existing pacemakers and worsening heart failure (HF).
  • Identifying predictors of left ventricular ejection fraction (LVEF) improvement post-CRT revision is crucial for optimizing patient care.

Purpose of the Study:

  • To identify factors predicting improvement in LVEF within one year following CRT revision in patients with pre-existing pacemakers.
  • To evaluate the real-world effectiveness of CRT revision in a cohort of heart failure patients.

Main Methods:

  • A retrospective study included 146 patients undergoing CRT revision between January 2012 and May 2018.
  • Left ventricular ejection fraction (LVEF) was measured pre-revision and at 3, 6, and 12 months post-upgrade.
  • Patient characteristics including rhythm, cardiomyopathy type, and baseline right ventricular (RV) pacing percentage were analyzed.

Main Results:

  • 68% of patients showed LVEF improvement at 6 months (mean ΔLVEF +6.7% ±9.6%), sustained at 12 months.
  • Patients with sinus rhythm, non-ischaemic cardiomyopathy (NICM), and ≥40% baseline RV pacing demonstrated significantly greater LVEF improvement compared to their counterparts.
  • No significant differences in LVEF improvement were observed based on gender, time since initial implant, or previous device type.

Conclusions:

  • Real-world data support current guidelines recommending CRT revision for select heart failure patients.
  • Non-ischaemic cardiomyopathy, sinus rhythm, and a high percentage of baseline RV pacing are key predictors of positive LVEF response to CRT revision.
  • These findings aid in patient selection and management strategies for CRT revision.
Abstract

Keywords:
CRT revisionCRT upgradeCardiac resynchronisation therapyHFrEFHeart failure

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