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Related Experiment Video

Updated: Apr 23, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Resynchronising care: addressing sex differences in cardiac resynchronisation therapy.

Laura van Pelt1, Jonas Erzeel2,3, Dominic A Theuns1

  • 1Department of Cardiology, Erasmus MC, Cardiovascular Institute, Thorax Center, Rotterdam, the Netherlands.

Eclinicalmedicine
|April 22, 2026
PubMed
Summary

Current cardiac resynchronisation therapy (CRT) guidelines neglect sex differences. Female patients show greater CRT benefits, yet underuse persists due to male-centric research and guidelines.

Keywords:
CRTCardiac resynchronisation therapyEquityHeart failureSex differencesWomen's health

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Area of Science:

  • Cardiology
  • Medical Research

Background:

  • Cardiovascular disease exhibits significant sex-based differences.
  • Current cardiac resynchronisation therapy (CRT) guidelines are primarily based on male-centric data.
  • Female patients are underrepresented in pivotal CRT trials, limiting sex-specific outcome analysis.

Purpose of the Study:

  • To highlight the underrepresentation of females in CRT research.
  • To discuss emerging evidence of sex-specific benefits of CRT.
  • To advocate for sex-specific research, guidelines, and clinical awareness in CRT.

Main Methods:

  • Review of existing literature on sex differences in cardiovascular disease and CRT.
  • Analysis of data regarding female patient enrollment in landmark CRT trials.
  • Synthesis of evidence on sex-specific CRT response and outcomes.

Main Results:

  • Female patients with heart failure with reduced ejection fraction (HFrEF) are less prevalent.
  • Females may benefit more from CRT at shorter QRS durations (130-149 ms) than males (≥150 ms).
  • Underuse of CRT in eligible females is linked to male-centric guidelines and limited clinical awareness.

Conclusions:

  • Sex-specific analyses are crucial for advancing CRT research and practice.
  • Current guidelines need revision to incorporate sex-specific recommendations for CRT.
  • Enhanced clinician awareness of sex-based differences is essential to improve CRT utilization in females.