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Updated: Jun 9, 2026

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

Global evidence on the cost-effectiveness of cardiac resynchronization therapy for heart failure: a systematic review

Kaltrina Bajraktari1, Zanfina Ademi2,3, Artan Bajraktari4,5

  • 1Faculty of Economy, AAB College, Prishtina, Kosovo.

Frontiers in Cardiovascular Medicine
|June 8, 2026
PubMed

Insights

Cardiac resynchronization therapy (CRT) is a cost-effective treatment for heart failure patients. CRT-P offers high value, while CRT-D is best for select high-risk individuals, improving outcomes and healthcare economics.

Area of Science:

  • Cardiology
  • Health Economics
  • Medical Technology Assessment

Background:

  • Heart failure (HF) presents a significant global health burden with high mortality and costs.
  • Despite advancements, HF management remains challenging, necessitating evaluation of treatment cost-effectiveness.
  • Cardiac resynchronization therapy (CRT) improves outcomes but incurs substantial healthcare expenses.

Purpose of the Study:

  • To systematically review and evaluate the cost-effectiveness of CRT compared to standard optimal medical therapy (OMT).
  • To assess the economic value of CRT in patients with heart failure who remain symptomatic on OMT.

Main Methods:

  • A systematic literature search was performed across major databases (Web of Science, PubMed, Scopus) from 2004 to 2025.
  • Included studies reported economic outcomes (QALYs, ICERs) comparing CRT + OMT vs. OMT alone, and CRT-P vs. CRT-D.
  • Costs were standardized to 2024 euros and evaluated against country-specific willingness-to-pay thresholds.

Main Results:

  • Eighteen studies were included, demonstrating CRT + OMT as highly cost-effective, with ICERs ranging from €3,048-€71,447/QALY gained.
  • CRT-D showed variable cost-effectiveness (€24,909-€105,572/QALY gained), often exceeding willingness-to-pay thresholds compared to CRT-P.
  • CRT-P emerged as a consistently cost-effective option across various settings.

Conclusions:

  • CRT, especially CRT-P, is a cost-effective intervention for symptomatic heart failure patients on OMT.
  • CRT-D's cost-effectiveness is variable, suggesting its use should be reserved for specific high-risk patient groups.
  • Prioritizing CRT-P aligns with delivering high-value care in advanced heart failure management.
Abstract

Keywords:
CRT-DCRT-PICERQALYcardiac resynchronization therapycost-Effectivenesshealth economicsheart failure

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