Related Experiment Video
Updated: Aug 6, 2026
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
Two-Lead Versus Conventional Three-Lead Cardiac Resynchronization Therapy in Heart Failure With Reduced Ejection
Sammy Dawoud1, Hany Dawoud1, Aakash Hans2
1From the Department of Medicine, International University of the Health Sciences, Basseterre, St. Kitts and Nevis.
Cardiology in Review
|July 21, 2026
Summary
Two-lead cardiac resynchronization therapy (CRT) offers similar outcomes to traditional 3-lead systems but with fewer complications. This lead-sparing approach is effective for selected heart failure patients.
Area of Science:
- Cardiology
- Medical Devices
- Clinical Trials
Background:
- Cardiac resynchronization therapy (CRT) is vital for heart failure (HF) with reduced ejection fraction.
- Conventional CRT-defibrillator (CRT-D) systems use 3 transvenous leads, increasing complication risks.
- Two-lead CRT systems present a less invasive alternative for specific patient groups.
Purpose of the Study:
- To compare the efficacy and safety of two-lead CRT (CRT-DX or single-pass Ventricular Dual-Dual CRT) versus conventional 3-lead CRT-D.
- To evaluate outcomes including mortality, complications, and echocardiographic response.
- To assess the feasibility of lead-sparing strategies in CRT.
Main Methods:
- Systematic literature search of PubMed, Embase, and Cochrane CENTRAL up to May 2026.
- Inclusion of randomized and observational studies comparing two-lead CRT with 3-lead CRT-D in adults.
- Analysis of primary outcomes: all-cause mortality, atrial lead complications, major complications, HF hospitalization. Secondary outcomes included echocardiographic measures and procedure time.
Main Results:
- Two-lead CRT significantly reduced atrial lead complications (OR 0.31) and major complications (OR 0.45) compared to 3-lead CRT-D.
- Procedure time was notably shorter with two-lead CRT (MD -13.11 minutes).
- No significant differences were found in all-cause mortality, HF hospitalization, or echocardiographic response between the groups.
Conclusions:
- Two-lead CRT-DX provides comparable clinical and echocardiographic outcomes to 3-lead CRT-D in selected patients without an atrial pacing indication.
- This approach reduces lead-related complications and procedure time, supporting lead-sparing strategies.
- Larger randomized trials with extended follow-up are warranted to confirm these findings.
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