Key result
LBBP-CRT shows a non-significant trend toward better 6-month LVEF versus biventricular CRT in LBBB.
Why the study?
LBBP has been suggested as an alternative CRT method, but whether it confers an advantage over traditional BiV pacing in clinical outcomes remained to be tested.
Does left bundle branch pacing improve electrical synchrony and clinical outcomes compared to traditional biventricular pacing in heart failure patients with true LBBB?
Population
Heart failure patients with LBBB by Strauss criteria and successful CRT
Comparison
LBBP-CRT vs BiV-CRT
Design
Propensity score-matched study
Follow-up
6-month
Authors
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Nonsignificant LVEF trend with LBBP-CRT warrants caution; leaves open superiority over BiV-CRT pending randomized trials in LBBB heart failure.
Cohort (n=42)
Does left bundle branch pacing improve electrical synchrony and clinical outcomes compared to traditional biventricular pacing in heart failure patients with true LBBB?
Absolute Event Rate: 50.9% vs 44.4%
p-value: p=.12
LBBP-CRT significantly improves electrical synchrony and shows a trend toward better echocardiographic response compared to traditional BiV-CRT in heart failure patients with true LBBB.
Guo et al. (2020) conducted a cohort in Heart failure with LBBB (n=42). Left bundle branch pacing (LBBP-CRT) vs. Biventricular pacing (BiV-CRT) was evaluated on Left ventricular ejection fraction (LVEF) at 6-month follow-up (p=.12). Left bundle branch pacing CRT showed a trend toward better left ventricular ejection fraction at 6 months compared to biventricular CRT (50.9% vs 44.4%, P=0.12) in heart failure patients with LBBB.