Effect of Cardiac Resynchronization Therapy on Libido and Erectile Dysfunction

Study Questions:

What are the effects of cardiac resynchronization therapy (CRT) on libido and erectile dysfunction (ED)?


Thirty-one male patients with advanced heart failure (HF), scheduled for implantation of a CRT device, were included in the study. Left ventricular systolic function, New York Heart Association (NYHA) class, libido, and ED were assessed before and 6 months after CRT. Libido and ED were evaluated with the Aging Male Symptoms (AMS) rating scale and internationally validated Sexual Health Inventory for Men (SHIM) questionnaire, respectively.


At the 6-month follow-up, the mean NYHA class improved from 3.4 ± 0.5 to 2.1 ± 0.6 (p < 0.001). On echocardiographic examination, an improvement in left ventricular ejection fraction (LVEF) from 18 ± 5% to 32 ± 6% was detected (p < 0.001). A significant increase in mean SHIM score and a significant decrease in mean AMS were noted. Changes in SHIM and AMS scores were correlated positively with the increase in LVEF (r = 0.47, p = 0.007 and r = −0.36, p = 0.04, respectively). Similarly, SHIM scores were correlated negatively (r = −0.57, p = 0.001) and AMS scores were correlated positively (r = 0.73, p = 0.0001) with the improvement in NYHA class.


The authors concluded that CRT results in a significant improvement in libido and erectile function in patients with congestive HF.


The study suggests that CRT results in significant improvement in libido, erectile function, and sexual performance as a consequence of the improvement in functional capacity and EF. It should be noted that the study had a small sample size, and was single-center and nonrandomized. Additional prospective studies are needed to confirm these observations, preferably with sildenafil as the comparator.

Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Implantable Devices, Acute Heart Failure

Keywords: Libido, Follow-Up Studies, Ventricular Function, Left, Erectile Dysfunction, Purines, Heart Failure, Reproductive Health, Piperazines, Sulfones, New York, Systole, Cardiac Resynchronization Therapy

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