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Introduction Cardiac resynchronisation therapy (CRT) reduces morbidity and mortality in selected patients with HFREF. While randomised trials have demonstrated long-term survival benefits, real-world outcome data in Irish cohorts remain limited.Aims To describe outcomes of patients post CRT implantation in University Hospital Galway. Primary outcomes were all-cause mortality and heart failure (HF) hospitalisations during follow-up, up to 7 years. Secondary outcomes included change in NYHA class, ejection fraction (EF), NtproBNP at 1 year.Methods We conducted a retrospective cohort study of all patients who received CRT between 1 Jan 2017 to 30 June 2023. Device implantation records and electronic hospital charts were reviewed for baseline and outcome data. Kaplan-Meier estimates were used. Paired t-test or Mann-Whitney U test were used for continuous variables.Results 91 patients were included. Median follow up was 3.0 years (IQR 1.8 to 5.1). Median age at implantation was 70.0 years (IQR 63.0 to 75.9); 81.3% were male. Median NYHA class was 3 (IQR 2 to 3) and mean baseline EF was 24.0% (+-SD 7.8). HF hospitalizations within 6 months pre CRT occurred in 23.1% of patients. By follow-up, 19.8% of patients had died - 16.7% from HF, 33.3%, non-cardiac causes, 50% unknown. Kaplan-Maier survival probability at 3 and 5 years was 0.852 (95% CI 0.746 to 0.916) and 0.738 (95% CI 0.598 to 0.853) respectively. Just 6.7% had HF hospitalizations during follow up. Mean EF improved to 33.2% (+-SD 12.1, p < 0.001). NYHA class improved to a median of 2 (IQR 1 to 2, p < 0.001). NtproBNP showed no statistically significant change (p = 0.165)Conclusion This is the largest and longest-followed Irish CRT cohort to date. We observed lower-than-expected mortality and HF hospitalisations at up to 7 years follow-up, with significant improvements in LVEF and NYHA class at 1 year.Abstract 27 Table 1Baseline characteristicsAbstract 27 Figure 1Kaplan-meier survival curve post CRT insertion