ArticleCirculation2023
Cardiac Resynchronization Therapy Improves Outcomes in Patients With Intraventricular Conduction Delay But Not Right Bundle Branch Block: A Patient-Level Meta-Analysis of Randomized Controlled Trials.
Article in Circulation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 31 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy
Resynchronization/Defibrillation for Ambulatory Heart Failure Trial
Biventricular Versus Right Ventricular Pacing in Heart Failure Patients With Atrioventricular Block (BLOCK HF)
REsynchronization reVErses Remodeling in Systolic Left vEntricular Dysfunction (REVERSE)
Who cites it
31 citing papers in PubMed, 53 citations in OpenAlex.
- In the Search of Noninvasive Methods Delineating Left Bundle Branch Block Amendable With Conduction System Pacing.Pacing and clinical electrophysiology : PACE · 2026Trial
- Refining left bundle branch block criteria for improved left bundle branch area pacing response in heart failure.Heart rhythm O2 · 2026Article
- Cardiac resynchronization therapy-defibrillator implantation in isolated left ventricular apical hypoplasia.European heart journal. Case reports · 2026Article
- Cardiac Resynchronization Therapy: A Review.JAMA · 2026Review
- Pleiotropic Effects of Cardiac Resynchronization Therapy on Cardiometabolic Modulation in Heart Failure.Medicina (Kaunas, Lithuania) · 2026Review
- Conduction System Pacing Improved Cardiac Functions, Myocardial Work and Functional Capacity in Heart Failure with Reduced Ejection Fraction and Right Bundle Branch Block.Journal of clinical medicine · 2025Article
- Clinical phenotypes and outcomes associated with improved left ventricular ejection fraction after biventricular pacing.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Expert Review of the Strategies to Optimize Long-Term Outcomes After Coronary Artery Bypass Grafting.Reviews in cardiovascular medicine · 2025Review
- Physiological pacing: mechanisms, clinical indications, and perspectives.European heart journal · 2025Review
- Device Therapy in Patients with Heart Failure: Is Medication Use Optimized and Are We Targeting Those Patients Most Likely to Benefit?CJC open · 2025Article
- Molecular Mechanisms of Cardiac Adaptation After Device Deployment.Journal of cardiovascular development and disease · 2025Review
- Cardiac rhythm devices in heart failure with reduced ejection fraction - role, timing, and optimal use in contemporary practice. European Journal of Heart Failure expert consensus document.European journal of heart failure · 2025Review
- Association of Left and Right Branch Blocks with Clinical Outcomes in Patients with Heart Failure with Preserved Ejection Fraction.The International journal of angiology : official publication of the International College of Angiology, Inc · 2025Article
- Towards Phenotyping Characteristics and Mechanism of Conduction Delay in Patients With Nonischemic Heart Failure With Reduced Ejection Fraction: Insights From Cardiac Magnetic Resonance Imaging.Journal of the American Heart Association · 2025Article
- Identifying non-responders to cardiac resynchronization therapy in the non-left bundle branch block.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- European Society of Cardiology (ESC) clinical consensus statement on indications for conduction system pacing, with special contribution of the European Heart Rhythm Association of the ESC and endorsed by the Asia Pacific Heart Rhythm Society, the Canadian Heart Rhythm Society, the Heart Rhythm Society, and the Latin American Heart Rhythm Society.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Tissue characterization using cardiac magnetic resonance imaging and response to cardiac resynchronization therapy.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Predictive Effect of Atypical Right Bundle-Branch Block on In-Hospital Sudden Cardiac Death and Cardiac Rupture and Long-Term Prognosis in Patients With Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention.Journal of the American Heart Association · 2025Article
- Accuracy of left ventricular mechanical dyssynchrony indices for mechanical characteristics of left bundle branch block using cardiovascular magnetic resonance feature tracking.European heart journal. Cardiovascular Imaging · 2025Article
- [Physiological pacing and heart failure : Hope or hype?]Herzschrittmachertherapie & Elektrophysiologie · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 10 institutions in 5 countries.
Funding
Abstract
backgroundBenefit from cardiac resynchronization therapy (CRT) varies by QRS characteristics; individual randomized trials are underpowered to assess benefit for relatively small subgroups.
methodsThe authors analyzed patient-level data from pivotal CRT trials (MIRACLE [Multicenter InSync Randomized Clinical Evaluation], MIRACLE-ICD [Multicenter InSync ICD Randomized Clinical Evaluation], MIRACLE-ICD II [Multicenter InSync ICD Randomized Clinical Evaluation II], REVERSE [Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction], RAFT [Resynchronization-Defibrillation for Ambulatory Heart Failure], BLOCK-HF [Biventricular Versus Right Ventricular Pacing in Heart Failure Patients with Atrioventricular Block], COMPANION [Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure], and MADIT-CRT [Multicenter Automatic Defibrillator Implantation Trial - Cardiac Resynchronization Therapy]) using Bayesian Hierarchical Weibull survival regression models to assess CRT benefit by QRS morphology (left bundle branch block [LBBB], n=4549; right bundle branch block [RBBB], n=691; and intraventricular conduction delay [IVCD], n=1024) and duration (with 150-ms partition). The continuous relationship between QRS duration and CRT benefit was also examined within subgroups defined by QRS morphology. The primary end point was time to heart failure hospitalization (HFH) or death; a secondary end point was time to all-cause death.
resultsOf 6264 patients included, 25% were women, the median age was 66 [interquartile range, 58 to 73] years, and 61% received CRT (with or without an implantable cardioverter defibrillator). CRT was associated with an overall lower risk of HFH or death (hazard ratio [HR], 0.73 [credible interval (CrI), 0.65 to 0.84]), and in subgroups of patients with QRS ≥150 ms and either LBBB (HR, 0.56 [CrI, 0.48 to 0.66]) or IVCD (HR, 0.59 [CrI, 0.39 to 0.89]), but not RBBB (HR 0.97 [CrI, 0.68 to 1.34];
conclusionsCRT is associated with reduced HFH or death in patients with QRS ≥150 ms and LBBB or IVCD, but not for those with RBBB. Aggregating RBBB and IVCD into a single "non-LBBB" category when selecting patients for CRT should be reconsidered. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifiers: NCT00271154, NCT00251251, NCT00267098, and NCT00180271.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.