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Updated: Jul 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

10.5K

Clinical outcomes and predictors of delayed echocardiographic response to cardiac resynchronization therapy

Naoki Tsurumi1, Yasuya Inden1, Satoshi Yanagisawa1

  • 1Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

Journal of Cardiovascular Electrophysiology
|October 28, 2023
PubMed

Insights

Delayed response to cardiac resynchronization therapy (CRT) has similar outcomes to early response. Factors like longer heart failure history and suboptimal LV lead placement predict delayed CRT response.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Clinical outcomes and mechanisms of delayed responses to cardiac resynchronization therapy (CRT) are not well understood.
  • Investigating early versus delayed CRT response is crucial for optimizing patient management.

Purpose of the Study:

  • To investigate differences in clinical outcomes between early and delayed responders to CRT.
  • To gain insight into the mechanisms underlying early and delayed responses to CRT.

Main Methods:

  • Retrospective study of 110 patients undergoing CRT implantation.
  • Response defined by ≥15% reduction in left ventricular (LV) end-systolic volume at 1 and 3 years.
  • Latest mechanical activation site (LMAS) identified using 2D speckle-tracking radial strain analysis.

Main Results:

  • 71% of patients showed an early response at 1 year.
  • Of early non-responders, 38% became delayed responders by 3 years.
  • Delayed and early responders had similar long-term prognosis; non-responders had worse outcomes.

Conclusions:

  • Prognosis after CRT is similar regardless of response timing (early vs. delayed).
  • Delayed CRT response is associated with longer heart failure duration, suboptimal LV lead placement, and shorter pre-QRS duration.
Abstract

Keywords:
LV lead positioncardiac resynchronization therapydelayed responselong-term prognosisspeckle tracking-echocardiography

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