Related Experiment Video

Updated: Jul 15, 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

10.5K

Time-trend treatment effect of cardiac resynchronization therapy with or without defibrillator on mortality: a

Boglárka Veres1,2, Péter Fehérvári2,3, Marie Anne Engh2

  • 1Heart and Vascular Center, Semmelweis University, Városmajor Str. 68, 1122 Budapest, Hungary.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|September 28, 2023
PubMed

Insights

Cardiac resynchronization therapy with a defibrillator (CRT-D) significantly reduces mortality compared to CRT with a pacemaker (CRT-P). However, this benefit was not observed in older patients or those with non-ischaemic heart conditions.

Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Research

Background:

  • Cardiac resynchronization therapy (CRT) improves outcomes in heart failure patients.
  • CRT devices include CRT with a pacemaker (CRT-P) and CRT with a defibrillator (CRT-D).
  • The comparative effectiveness of CRT-D versus CRT-P on mortality requires further investigation.

Purpose of the Study:

  • To compare the impact of CRT-D versus CRT-P on all-cause mortality.
  • To identify patient subgroups where CRT-D may not offer a survival benefit.
  • To analyze temporal trends in treatment effects and patient characteristics.

Main Methods:

  • Systematic review and meta-analysis of 26 observational studies.
  • Included 128,030 patients with CRT devices (55,469 CRT-P, 72,561 CRT-D).
  • Focused on studies published up to October 2021, analyzing mortality data.

Main Results:

  • CRT-D significantly reduced all-cause mortality by nearly 20% compared to CRT-P (HR: 0.85).
  • This survival benefit was not observed in patients with non-ischaemic aetiology or those over 75 years old.
  • Treatment effects and patient characteristics (age, aetiology) showed significant time trends.

Conclusions:

  • CRT-D is associated with lower mortality risk than CRT-P in the general CRT population.
  • CRT-D superiority is limited in specific subgroups, including older patients and those with non-ischaemic heart disease.
  • Evolving patient profiles and treatment strategies may influence the observed time-trend in CRT effectiveness.
Abstract

Keywords:
CRT-P vs. CRT-DCardiac resynchronization therapyHeart failureMeta-analysisSudden cardiac death

More Related Videos

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

665
Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy07:02

Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy

Published on: September 9, 2020

6.4K

Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
11
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
14
Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
19
Cardiopulmonary Resuscitation III: AED Use01:23

Cardiopulmonary Resuscitation III: AED Use

Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
37
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
16
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
12