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Updated: Jun 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

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Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch block

Athanasios Saplaouras1, Konstantinos Vlachos1, Panagiotis Mililis1

  • 1Arrhythmia Unit, Onassis Cardiac Surgery Center, Athens, Greece.

ESC Heart Failure
|September 20, 2024
PubMed

Insights

Stricter Strauss criteria for left bundle branch block (St-LBBB) improve cardiac resynchronization therapy (CRT) response in heart failure patients. St-LBBB identifies patients with non-ischaemic cardiomyopathy who benefit most from CRT, reducing hospitalizations and mortality.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Left bundle branch block (LBBB) predicts response to cardiac resynchronization therapy (CRT).
  • A substantial proportion of patients do not benefit from CRT.
  • The diagnostic utility of stricter criteria for LBBB (St-LBBB) in predicting CRT outcomes requires further investigation.

Purpose of the Study:

  • To evaluate the impact of St-LBBB criteria on CRT response.
  • To assess the effect of St-LBBB on heart failure hospitalizations, ventricular arrhythmia (VA) events, and mortality in patients receiving CRT.

Main Methods:

  • Retrospective analysis of prospectively collected data from heart failure patients with LBBB undergoing CRT implantation.
  • Patients were categorized into St-LBBB and non-St-LBBB groups.
  • Outcomes including CRT response, hospitalizations, VA events, and mortality were compared between groups.

Main Results:

  • Patients meeting St-LBBB criteria demonstrated significantly higher CRT response rates (P < 0.01).
  • The greatest benefit was observed in patients with non-ischaemic cardiomyopathy (NICM) and St-LBBB, showing reduced heart failure hospitalizations (P < 0.0001), VA events (P < 0.001), and mortality (P < 0.0001).
  • St-LBBB identified a subgroup with significantly lower VA incidence in NICM patients (P = 0.049).

Conclusions:

  • St-LBBB criteria enhance patient selection for CRT, particularly benefiting those with NICM.
  • The St-LBBB classification is associated with improved CRT response, reduced hospitalizations, fewer VA events, and lower mortality.
  • Further research is warranted to fully elucidate the role of St-LBBB in optimizing CRT outcomes.
Abstract

Keywords:
CRT responseStrauss LBBBischaemic cardiomyopathynon‐ischaemic cardiomyopathyventricular arrhythmias

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