What does this research mean for the field?

The combination of dynamic atrioventricular delays with multipoint pacing improves echocardiographic and clinical response rates in patients with left bundle branch block receiving cardiac resynchronization therapy. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Evaluate the 6-month clinical and echocardiographic responses to SyncAV in conjunction with different pacing techniques in CRT patients.

March 1, 2026

Left Ventricular and Biventricular Multipoint Pacing With Dynamic Atrioventricular Delays: 6-Month Cardiac Resynchronization Therapy Response.

Key Result

SyncAV combined with either biventricular or LV-only MultiPoint Pacing yielded comparable 6-month CRT response with 85% vs 74% LVESV and 94% vs 77% LVEF responders.

Key Points

Evaluate the 6-month clinical and echocardiographic responses to SyncAV in conjunction with different pacing techniques in CRT patients.
Multicenter clinical study with patients indicating need for cardiac resynchronization therapy (CRT).
Randomized patients to either biventricular multipoint pacing combined with SyncAV or left ventricle-only multipoint pacing with SyncAV.
Patient-specific SyncAV offsets were used to minimize QRS duration at implant.
Measured metrics included left ventricle end-systolic volume, ejection fraction, NYHA class, quality of life, and Packer score at baseline and 6 months post-implant.
70 patients completed the CRT implant and follow-up at 6 months with results reported for two pacing groups.
Both MPP+SyncAV and LVMPP+SyncAV showed similar responder rates for ΔESV ≤ -15% (85% vs. 74%) and ΔEF ≥ 5% (94% vs. 77%).
No statistically significant differences in improvements in NYHA class, QoL, and Packer score between groups; all p > 0.05.

Structured PICO

Does biventricular multi-site pacing with dynamic AV delays improve echocardiographic and clinical response compared to LV-only multi-site pacing with dynamic AV delays in CRT-indicated patients with LBBB?

Population

70 CRT-indicated patients with LBBB and intact AV conduction (PR < 250 ms), mean age 69, 73% male, international.

Intervention

Biventricular multi-site left ventricular pacing with dynamic atrioventricular delays (MPP+SyncAV: RV + LV1 + LV2 pacing)

Comparator

Left ventricular-only multi-site pacing with dynamic atrioventricular delays (LVMPP+SyncAV: LV1 + LV2 pacing)

Outcome

6-month echocardiographic and clinical response (LV end-systolic volume, LV ejection fraction, NYHA class, quality of life score, and Packer score)surrogate

Both biventricular and LV-only multi-site pacing combined with dynamic AV delays yielded promising and comparable 6-month echocardiographic and clinical responses in CRT-indicated patients with LBBB.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

BACKGROUND: The response to cardiac resynchronization therapy (CRT) can depend on when and where the right and left ventricles (RV, LV) are paced. Dynamic atrioventricular (AV) delays (SyncAV CRT, Abbott) and multi-site LV pacing (e.g., MultiPoint Pacing MPP, Abbott) are features that may enhance CRT response. Their combined impact has not been evaluated in a chronic clinical setting. OBJECTIVE: Evaluate the 6-month echocardiographic and clinical response to SyncAV when combined with either biventricular MPP (MPP+SyncAV: RV + LV1 + LV2 pacing) or LV-only MPP (LVMPP+SyncAV: LV1 + LV2 pacing). METHODS: CRT-indicated patients with LBBB and intact AV conduction (PR 0.05 for all. CONCLUSIONS: The 6-month echocardiographic (ESV, EF) and clinical (NYHA class, QoL, Packer) response rates observed in LBBB patients were promising when SyncAV was combined with MPP, in both biventricular and LV-only pacing modes. TRIAL REGISTRATION: NCT03567096.

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