Why the study?
While His bundle pacing provides physiologic pacing with reduced risk of heart failure hospitalization and mortality, the clinical outcomes of left bundle branch area pacing compared to His bundle pacing remained to be determined.
Does left bundle branch area pacing reduce death or heart failure hospitalization compared to His bundle pacing in patients with AV block or AV node ablation requiring permanent pacemaker implantation?
Population
359 patients with AV block/AV node ablation undergoing de novo permanent pacemaker implantation
Comparison
LBBAP vs HBP
Design
Observational registry study
Key result
Left bundle branch area pacing resulted in similar rates of death or heart failure hospitalization compared to His bundle pacing (17.3% vs 24.5%; HR 1.15; 95% CI 0.72-1.82; p=0.552).
Authors
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LBBAP may support consideration as alternative to HBP; leaves open whether RCTs confirm equivalence in AV block pacing.
Observational (n=359)
Does left bundle branch area pacing reduce death or heart failure hospitalization compared to His bundle pacing in patients with AV block or AV node ablation requiring permanent pacemaker implantation?
Effect estimate: HR 1.15 (95% CI 0.72-1.82)
Absolute Event Rate: 17.3% vs 24.5%
p-value: p=.552
Left bundle branch area pacing provides similar clinical outcomes regarding death and heart failure hospitalization compared to His bundle pacing in patients requiring permanent pacemaker implantation.
Vijayaraman et al. (2022) conducted an observational in AV block/AV node ablation needing permanent pacemaker implantation (n=359). Left bundle branch area pacing (LBBAP) vs. His bundle pacing (HBP) was evaluated on Composite endpoint of time to death from any cause or heart failure hospitalization (HFH) (HR 1.15, 95% CI 0.72-1.82, p=.552). Left bundle branch area pacing resulted in similar rates of death or heart failure hospitalization compared to His bundle pacing (17.3% vs 24.5%; HR 1.15; 95% CI 0.72-1.82; p=0.552).
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