Aims Cardiac resynchronization therapy (CRT) is currently limited to those with left ventricular ejection fraction (LVEF) ≤35. To evaluate whether patients with LVEF >35 might benefit from CRT, we performed a retrospective analysis of the predictors of response to CRT (PROSPECT) database. Methods and results PROSPECT was a prospective, multicentre study that enrolled CRT patients based on enrolling centre-evaluated LVEF 35 (OVER35) were compared with those whose LVEF was 35. At entry, OVER35 had smaller LV volumes, shorter QRS duration, shorter 6-min walk distance, and were more likely to have ischaemic aetiology than UNDER35. Outcomes were comparable between the groups, with 62.8 of OVER35 improved in CCS (70.2 in UNDER35) and 50.8 of OVER35 improved in LVESV (57.8 in UNDER35). Conclusion Patients with LVEF >35, New York heart association functional Class III-IV status, and QRS >130 ms appear to derive clinical and structural benefit from CRT. As CRT may offer a valuable option for these patients, this hypothesis should be formally tested in a prospective, randomized multicentre trial.
- Cardiac resynchronization therapy
- Diastolic heart failure
- Heart failure
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine