Demographic Profile of Cardiac Resynchronization Therapy Recipients in a Saudi Tertiary Center: A Descriptive...

Women remain underrepresented in landmark cardiac resynchronization therapy (CRT) trials, despite evidence suggesting they may derive substantial clinical benefit. Age at implantation also influences outcomes and long-term management. However, demographic and clinical data on CRT recipients in Saudi Arabia remain limited. This study aimed to describe the sex distribution and age profile of CRT recipients in a tertiary Saudi center and to contextualize these findings within international CRT trial and registry data.

We retrospectively reviewed consecutive CRT implantations performed between January 2017 and December 2021 at a tertiary cardiac center in Jeddah, Saudi Arabia. Demographic and clinical variables, including age and sex, underlying cardiomyopathy, New York Heart Association (NYHA) class, conduction morphology, atrial fibrillation, and baseline echocardiographic parameters, were collected. Descriptive statistics were summarized and compared narratively with published data from major CRT randomized controlled trials (RCTs) and large international registries.

Among 53 CRT recipients, 18 (34.0%) were women (95% confidence interval [CI]: 22.7-47.4). Mean age was 65.5 ± 10.5 years (95% CI: 62.6-68.4). Ischemic cardiomyopathy accounted for 54.7% of cases, left bundle branch block morphology was present in 69.8%, and the mean left ventricular ejection fraction was 27% ±6%. Most patients (67.9%) were in NYHA Class III. Female proportion was broadly similar to that reported in large international registries (≈30%-36%) and higher than landmark RCTs (≈20%-25%). Age distribution was comparable to global CRT cohorts. Most patients received CRT-D devices (94.3%).

CRT recipients in this Saudi cohort exhibited demographic and clinical characteristics comparable to international real-world CRT populations. These findings provide much-needed foundational data on CRT utilization in Saudi Arabia and highlight the importance of establishing multicenter national CRT registries to better characterize access patterns and identify potential sex- or age-related disparities in advanced heart failure therapy.