In another trial 143 of 809 patients with QRS duration <130 ms, after a median of 19 months, a nonsignificant trend toward higher all‐cause death or HFH in the CRT group was demonstrated; there were significantly more deaths in the CRT group.
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2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure.
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Additional studies are needed to better understand the sex‐specific differences in CRT response among patients with HF, LBBB, and QRS duration <150 ms. 2 Two meta‐analyses 95 , 114 focused on QRS duration found no benefit in any of the 5 trials studied with QRS durations <150 ms, though CARE‐HF showed a trend toward significance for QRS duration 120–159 ms. 90 , 91 , 92 , 94 , 96 However, the other trials did not directly report HRs for all QRS durations, and QRS durations did not always correlate with true LBBB.
Additional studies are needed to better understand the sex‐specific differences in CRT response among patients with HF, LBBB, and QRS duration <150 ms. 2 Two meta‐analyses 95 , 114 focused on QRS duration found no benefit in any of the 5 trials studied with QRS durations <150 ms, though CARE‐HF showed a trend toward significance for QRS duration 120–159 ms. 90 , 91 , 92 , 94 , 96 However, the other trials did not directly report HRs for all QRS durations, and QRS durations did not always correlate with true LBBB.
When stratified by QRS duration, women had a significant reduction in HF or mortality at all ranges of QRS duration, while men exhibited more benefit at ≥150 ms (although trending toward significance with QRS duration <150 ms). 9 , 128 A meta‐analysis 120 of 4076 patients from the RAFT, MADIT‐CRT, and REVERSE trials—comparing CRT‐D to ICD therapy in patients with predominantly NYHA class II HF—reported the sex‐specific benefit in HF or mortality in those with LBBB stratified by QRS durations in 10‐ms increments from 120 to ≥180 ms.