Related Experiment Video
Updated: Aug 6, 2026
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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
Inpatient Cardiac Resynchronization Therapy During Heart Failure Hospitalization: A Distinct High-Risk Phenotype
Oliver Rees1,2, James Dargan1,2, Jemima Weir1
1St George's University Hospitals NHS Foundation Trust, London, UK.
Pacing and Clinical Electrophysiology : PACE
|July 20, 2026
Summary
Patients receiving cardiac resynchronization therapy (CRT) during a heart failure hospitalization (HFH) have worse outcomes than those receiving it later. Inpatient CRT is linked to higher re-hospitalization and shorter survival, indicating a need for better patient selection.
Area of Science:
- Cardiology
- Heart Failure Management
- Medical Device Therapy
Background:
- Cardiac resynchronization therapy (CRT) use during heart failure hospitalizations (HFH) is common but its role remains uncertain.
- Hospitalized patients were historically excluded from landmark CRT trials, leading to a lack of evidence for this specific population.
- This study addresses the clinical uncertainty surrounding inpatient CRT during HFH.
Purpose of the Study:
- To compare the clinical characteristics of patients undergoing inpatient CRT during HFH versus those receiving outpatient CRT after HFH.
- To evaluate and compare post-implantation outcomes, including heart failure re-hospitalization and long-term survival, between the two groups.
- To identify if the timing of CRT implantation (inpatient vs. outpatient) impacts patient outcomes.
Main Methods:
- Utilized institutional CRT data linked with the National Heart Failure Audit (January 2014 - December 2024).
- Stratified patients into inpatient CRT during HFH and deferred outpatient CRT groups.
- Employed multivariable Cox proportional hazards modeling to assess mortality risk associated with implantation setting.
Main Results:
- Inpatient CRT patients exhibited poorer renal function, higher rates of ischemic cardiomyopathy, and more frequent prior HF hospitalizations.
- The inpatient CRT group had a significantly higher risk of heart failure re-hospitalization within one year (23.1% vs. 7.8%).
- Median survival was substantially shorter for the inpatient group (1192 days vs. 2262 days), with deferred outpatient CRT associated with lower mortality (HR 0.56).
Conclusions:
- Patients receiving inpatient CRT during HFH represent a higher-risk subgroup with distinct clinical profiles.
- Inpatient CRT during HFH is associated with worse post-implantation outcomes, including increased re-hospitalization and reduced survival.
- Further prospective research is essential to optimize patient selection criteria for inpatient CRT during heart failure hospitalizations.
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