Related Experiment Video

Updated: Jul 10, 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

The Barthel Index in Predicting Response to Cardiac Resynchronization Therapy and Clinical Outcomes in Patients With

Kailun Zhu1, Haojie Zhu1, Xiaofei Li1

  • 1Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Clinical Cardiology
|July 9, 2026
PubMed

Insights

The Barthel Index (BI) effectively predicts cardiac resynchronization therapy (CRT) response and improves outcomes in heart failure (HF) patients with left bundle branch block (LBBB). Higher BI scores indicate better prognosis and reduced hospitalizations.

Area of Science:

  • Cardiology
  • Heart Failure Management
  • Medical Devices

Background:

  • Cardiac resynchronization therapy (CRT) response in heart failure (HF) is complex.
  • Limited data exists on the association between activities of daily living, measured by the Barthel Index (BI), and CRT outcomes.
  • Non-ischemic HF patients with left bundle branch block (LBBB) represent a significant population for CRT.

Purpose of the Study:

  • To prospectively evaluate the predictive value of the Barthel Index (BI) for CRT response.
  • To assess the association of BI with long-term clinical outcomes in non-ischemic HF patients with LBBB.
  • To identify optimal BI cutoffs for predicting CRT success.

Main Methods:

  • A prospective observational study enrolled 271 non-ischemic HF patients with LBBB undergoing CRT.
  • Barthel Index (BI) was assessed pre-CRT implantation.
  • Primary endpoint: CRT response (LVEF improvement ≥5% at 6 months). Secondary endpoint: All-cause mortality and HF hospitalization (HFH).

Main Results:

  • CRT response rate was 68.67% in 249 patients completing 6-month follow-up.
  • BI was an independent predictor of CRT response (OR=1.37, p=0.002), with an optimal cutoff of 95.
  • BI > 95 significantly reduced the risk of mortality/HFH by 88% (aHR=0.116, p<0.001) over median 33.94-month follow-up, mainly due to HFH reduction.

Conclusions:

  • The Barthel Index (BI) serves as a simple, cost-effective predictor of CRT response in non-ischemic HF patients with LBBB.
  • Higher BI scores correlate with improved left ventricular ejection fraction (LVEF) and better long-term prognosis.
  • BI integration into clinical assessment can optimize patient selection and management for CRT.
Abstract

Keywords:
barthel indexcardiac resynchronization therapyechocardiographic responseheart failureleft bundle branch area pacing

More Related Videos

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Related Concept Videos

Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Heart Failure Drugs: &#946;-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...