09/10/2026
⚡ Who responds best to CRT-D upgrade?
The recently published post-hoc analysis of the randomized BUDAPEST-CRT Upgrade trial in “Clinical Research in Cardiology” (Springer Nature) provides new insights into predictors of reverse remodeling after CRT upgrade.
📊 Methods:
Among 360 patients with HFrEF and ≥ 20% RV pacing burden randomized to CRT-D upgrade vs. ICD alone, echocardiographic response was defined as ≥15% reduction in left ventricular end-systolic volume (LVESV) at 12 months.
💡 Main Results:
59% of 275 patients with available follow-up echocardiography showed significant reverse remodeling. Randomization to CRT-D upgrade, higher RV pacing burden at enrollment, non-ischemic cardiomyopathy, and lateral LV lead position were independent predictors of echocardiographic response. These findings may help to identify patients who particularly benefit from CRT-D upgrade and support a more individualized approach to device therapy.
👥 Authors:
Eperke Merkel, Richárd Masszi, Bálint Lakatos, Robert Hatala, Boglárka Veres, Alexandra Fábián, István Osztheimer, László Gellér, Tamás Urbán, Csaba Horváth, Scott D. Solomon, Valentina Kutyifa, Attila Kovács, Béla Merkely & Annamária Kosztin
Read the full study in „Clinical Research in Cardiology“:
➡️ https://link.springer.com/article/10.1007/s00392-026-02963-x
