Key result
Adding CRT during CABG is linked to ~75% lower HF readmission and reduced all-cause mortality.
Why the study?
Heart failure remains the leading cause of death and rehospitalization among cardiomyopathic patients undergoing CABG, motivating an evaluation of adding CRT to CABG.
Does adding cardiac resynchronization therapy (CRT) to CABG reduce heart failure readmission and all-cause mortality in patients with ischemic cardiomyopathy and electromechanical dyssynchrony?
Meta-Analysis (n=300)
Does adding cardiac resynchronization therapy (CRT) to CABG reduce heart failure readmission and all-cause mortality in patients with ischemic cardiomyopathy and electromechanical dyssynchrony?
In patients with ischemic cardiomyopathy and dyssynchrony undergoing CABG, concomitant epicardial CRT implantation significantly reduces heart failure readmissions and all-cause mortality.
Answers are grounded in this paper and cite their sources.
May support adding CRT to CABG in ischemic cardiomyopathy with dyssynchrony; extends evidence from prior trials but needs larger confirmation.
INTRODUCTION: Heart failure (HF) continues to be the leading cause of death and rehospitalization among cardiomyopathic patients undergoing coronary artery bypass grafting (CABG). OBJECTIVES: To systematically evaluate the effect of adding cardiac resynchronization therapy (CRT) to CABG versus CABG alone for patients with concomitant ischemic cardiomyopathy and electromechanical dyssynchrony. (PROSPERO ID: CRD420251006918) METHODS: A comprehensive literature search was conducted using PubMed, Web of Science, and Scopus to identify clinical trials and cohort studies evaluating the impact of inserting a CRT device during CABG surgery on survival and rehospitalization outcomes. A total of 3 studies involving 300 patients were included: 150 underwent CABG alone, and 150 received both CABG and CRT. RESULTS: The meta-analysis of two studies (n = 200) showed that adding CRT during CABG was associated with lowering the probability of HF readmission (RR = 0.25, 95% CI [0.13-0.49], P < 0.0001) and of all-cause mortality (RR = 0.44, 95% CI [0.25-0.78], p = 0.0048) in the targeted patient population. Analyses according to study design demonstrated consistent treatment effects across randomized and observational evidence, with no significant subgroup differences. CONCLUSION: In patients with ischemic cardiomyopathy and electromechanical dyssynchrony undergoing CABG, perioperative epicardial CRT implantation may be associated with decreased HF rehospitalization and all-cause mortality rates. However, given the limited number of included studies and small cumulative sample size, these findings should be considered hypothesis-generating, and large-scale confirmatory randomized trials are warranted. REGISTRATION: The study protocol was prospectively registered in PROSPERO. (CRID: CRD420251006918).
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Saeed et al. (2026) conducted a meta-analysis in Ischemic cardiomyopathy and electromechanical dyssynchrony (n=300). Cardiac resynchronization therapy (CRT) vs. CABG alone was evaluated on Heart failure readmission (RR 0.25, 95% CI 0.13-0.49, p=<0.0001). Adding CRT during CABG was associated with a lower probability of HF readmission (RR 0.25; 95% CI 0.13-0.49; P<0.0001) and all-cause mortality compared to CABG alone.
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