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Updated: Oct 10, 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

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Evaluation of potential underuse of cardiac resynchronization therapy for heart failure with reduced ejection

Makoto Takano1, Yui Nakayama1, Hisao Matsuda1

  • 1Division of Cardiology Department of Internal Medicine Yokohama City Seibu Hospital St. Marianna University School of Medicine Yokohama Yokohama City Japan.

Journal of Arrhythmia
|December 10, 2021
PubMed

Insights

Eligible heart failure patients not receiving cardiac resynchronization therapy (CRT) experienced significantly more hospitalizations and deaths. This highlights the underutilization of CRT in heart failure management.

Area of Science:

  • Cardiology
  • Heart Failure Management

Background:

  • Increasing prevalence of chronic heart failure in Japan.
  • Stagnant rates of cardiac resynchronization therapy (CRT) despite growing heart failure cases.
  • Need to evaluate outcomes for eligible CRT patients not receiving the therapy.

Purpose of the Study:

  • To assess the clinical impact of underutilized cardiac resynchronization therapy (CRT) in eligible heart failure patients.
  • To compare outcomes between heart failure patients eligible for CRT and those ineligible, all receiving only pharmacological therapy.

Main Methods:

  • Retrospective analysis of 214 heart failure patients with left ventricular ejection fraction (LVEF) ≤ 50% who did not receive CRT.
  • Stratification into Group A (26 eligible for CRT) and Group B (188 ineligible for CRT).
  • Comparison of cumulative hospitalizations for heart failure and cardiogenic deaths over a 675-day follow-up.

Main Results:

  • No significant differences in baseline characteristics (age, sex, heart disease) between groups.
  • Group A (eligible for CRT) had significantly higher rates of heart failure hospitalizations and cardiogenic deaths compared to Group B (log-rank test, P < .01).
  • Hazard ratio for adverse events in Group A was 3.05 (95% CI, 1.31-7.09).

Conclusions:

  • Only 12% of evaluated heart failure patients were eligible for CRT, indicating significant underutilization.
  • Despite eligibility, no patients in the study received CRT, leading to worse clinical outcomes.
  • Strong recommendation for increased CRT utilization in indicated heart failure patients.
Abstract

Keywords:
cardiac resynchronization therapyguidelineheart failureimplantable cardioverter defibrillatorleft bundle branch block

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