Influence of Cardiac Resynchronization Therapy in Patients With Left Ventricular Assist Device
Miloud Cherbi1, Vincent Galand2, Erwan Flecher3
1From the Cardiology Department, Toulouse University Hospital, Toulouse, France.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|October 27, 2025
Summary
Cardiac resynchronization therapy (CRT) in patients with left ventricular assist devices (LVAD) did not improve survival or reduce ventricular arrhythmias (VAs). The study found no significant benefit, with some patients experiencing device complications.
Area of Science:
- Cardiology
- Medical Devices
- Clinical Research
Background:
- Many patients with left ventricular assist devices (LVAD) also receive cardiac resynchronization therapy (CRT).
- The impact of CRT on survival and ventricular arrhythmias (VAs) in LVAD recipients is not well understood.
Purpose of the Study:
- To evaluate the association between CRT and survival outcomes in LVAD patients.
- To assess the effect of CRT on mortality and the incidence of VAs in this population.
Main Methods:
- Analysis of patients from the multicenter ASSIST-ICD registry.
- Utilized a 1:1 propensity score-matched cohort of 652 LVAD recipients.
- Assessed all-cause mortality, cardiovascular/noncardiovascular mortality, and early/late VAs.
Main Results:
- CRT use was not associated with improved survival (HR: 1.31 [0.94-1.82]).
- No significant association was found with cardiovascular mortality (HR: 1.14 [0.68-1.90]) or noncardiovascular mortality (HR: 0.88 [0.56-1.40]).
- CRT did not reduce the incidence of early (OR: 0.71 [0.43-1.16]) or late (OR: 1.24 [0.73-2.11]) VAs, and 13.6% of CRT patients had device-related complications.
Conclusions:
- Concomitant CRT with LVAD does not appear to offer a survival benefit.
- The findings suggest potential risks associated with device-related complications in CRT patients with LVAD.
- Further randomized trials are needed to clarify the role of pre-existing CRT in LVAD recipients.
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