Some heart failure patients could have electrical dyssynchrony (indicators include LBBB1 or QRS ≥ 120 ms2) and may benefit from cardiac resynchronization therapy (CRT).3
For these patients, cardiac resynchronization therapy (CRT), in addition to guideline directed medical therapy (GDMT), is the only therapy clinically proven to help4:
The Prevalence of Electrical Dyssynchrony† is Approximately 35% among Patients with More Symptomatic Heart Failure14
*CRT is the only proven treatment for electrical dyssynchrony supported by randomized clinical trials.3,5
†Patients with a prolonged QRS (>120 ms).
Kumar V, Venkataraman R, Aljaroudi W, et al. Implications of left bundle branch block in patient treatment. Am J Cardiol. January 15, 2013;111(2):291-300.
Suever JD, Hartlage GR, Magrath RP 3rd, Iravanian S, Lloyd MS, Oshinski JN. Relationship between mechanical dyssynchrony and intra-operative electrical delay times in patients undergoing cardiac resynchronization therapy. J Cardiovasc Magn Reson. January 6, 2014;16:4.
Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. October 15, 2015;62(16):e147-e239.
Cleland JG, Daubert JC, Erdmann E, et al. Longer-term effects of cardiac resynchronization therapy on mortality in heart failure [the CArdiac REsynchronization-Heart Failure (CARE-HF) trial extension phase]. Eur Heart J. August 2006;27(16):1928-1932.
Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. June 13, 2002;346(24):1845-1853.
Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. May 28, 2003;289(20):2685-2694.
Gold MR, Padhiar A, Mealing S, Sidhu MK, Tsintzos SI, Abraham WT. Long-Term Extrapolation of Clinical Benefits Among Patients With Mild Heart Failure Receiving Cardiac Resynchronization Therapy: Analysis of the 5-Year Follow-Up From the REVERSE Study. JACC Heart Fail. September 2015;3(9):691-700.
Bristow MR, Saxon LA, Boehmer J, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. May 20, 2004;350(21):2140-2150.
Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. April 14, 2005;352(15):1539-1549.
Moss AJ, Hall WJ, Cannom DS, et al. Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med. October 1, 2009;361(14):1329-1338.
Tang AS, Wells GA, Talajic M, et al. Cardiac-resynchronization therapy for mild-to-moderate heart failure. N Engl J Med. December 16, 2010;363(25):2385-2395.
Curtis AB, Worley SJ, Adamson PB, et al. Biventricular pacing for atrioventricular block and systolic dysfunction. N Engl J Med. April 25, 2013;368(17):1585-1593.
Linde C, Abraham WT, Gold MR, et al. Randomized trial of cardiac resynchronization in mildly symptomatic heart failure patients and in asymptomatic patients with left ventricular dysfunction and previous heart failure symptoms. J Am Coll Cardiol. December 2, 2008;52(23):1834-1843.
Jaffe LM, Morin DP. Cardiac resynchronization therapy: history, present status, and future directions. Ochsner J. 2014;14(4):596-607.