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June 27, 2026EP EuropaceOpen Access

CRT deactivation in LVAD patients does not reduce arrhythmias but is linked to improved transplant-free survival.

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Why the study?

Does deactivating CRT therapy reduce ventricular arrhythmias or improve survival in patients with LVAD support?

Population

158 patients with active CRT devices who underwent continuous-flow LVAD implantation, excluding those who…

Comparison

Deactivation of CRT therapy during LVAD support vs Continuation of CRT therapy (CRT-on)

Design

Cohort

Follow-up

3 years

Key result

CRT deactivation in LVAD patients had no significant impact on 1-year ventricular arrhythmia incidence (40% vs 37%, p=0.649) but was associated with improved 3-year transplant-free survival.

Authors

EEE EfimovaSZS ZeynalovaSKS Koenig

Discussion

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Overview

CRT deactivation was associated with better transplant-free survival post-LVAD; observational data leave open need for randomized confirmation.

Key Points

  • This study aimed to determine the effects of deactivating CRT therapy on ventricular arrhythmias and survival outcomes in LVAD patients.
  • Retrospective cohort study of 178 LVAD patients with active CRT devices from September 2011 to December 2023.
  • Inclusion of 158 LVAD patients after excluding heart transplant recipients and those with CRT duration <1 month post-LVAD implantation.
  • Assessment of arrhythmia incidence and survival outcomes comparing CRT-on and CRT-off groups.
  • Ventricular arrhythmias incidence was similar between CRT-on (37%) and CRT-off groups (40%, p=0.649).
  • CRT deactivation improved transplant-free survival (p=0.020); 3-year survival rates were 49% (CRT-on) vs. 81% (CRT-off).
  • No significant differences in overall survival between the CRT-on and CRT-off groups.

Study Design

Type

Cohort (n=158)

Multicenter

No

Structured PICO

Does deactivating CRT therapy reduce ventricular arrhythmias or improve survival in patients with LVAD support?

P
Population
158 LVAD patients with an active CRT device (mean age 63, 11% female), followed for up to 3 years.
E
Exposure
Deactivation of CRT therapy (CRT turned off) during LVAD support
C
Comparator
Continuation of CRT therapy (CRT-on)
O
Outcome
Incidence of ventricular arrhythmias (including both MVT and VF) within the first year after LVAD implantation, transplant-free survival, and overall survivalhard clinical

Main Result

Absolute Event Rate: 40% vs 37%

p-value: p=0.649

Deactivating CRT in LVAD patients does not increase ventricular arrhythmias and may be associated with improved transplant-free survival.

Cite This Study

Efimova et al. (2026) conducted a cohort in LVAD patients with an active CRT device (n=158). CRT deactivation vs. CRT continuation (CRT-on) was evaluated on Incidence of ventricular arrhythmias within the first year (p=0.649). CRT deactivation in LVAD patients had no significant impact on 1-year ventricular arrhythmia incidence (40% vs 37%, p=0.649) but was associated with improved 3-year transplant-free survival.

synapsesocial.com/papers/6a3f9785125782b61d865787https://doi.org/10.1093/europace/euag105.836
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Contemporary Management of Cardiac Implantable Electronic Devices in the LVAD Era: Evidence, Controversies, and Clinical Implications2026 · 1 citations
  2. 2CRT: long-term response and predictors of mortality in left ventricular-only fusion pacing2026
  3. 3Impact of Using Different Advanced Pacing Algorithms and Modalities on Improving the Efficacy and Response of Cardiac Resynchronization Therapy2025
  4. 4CRT: comparative long-term outcomes of LV-only fusion pacing versus optimized biventricular pacing2026
  5. 5Survival of patients undergoing cardiac resynchronization therapy with or without defibrillator: the RESET-CRT project2022 · 52 citations