Key result
LBBAP is associated with QRS narrowing and improved LV systolic function in ~92% of patients.
Why the study?
Proof of conduction system capture improves outcomes in LBBAP, prompting the need to evaluate LBBAP-CRT with mandatory confirmation of LBBA capture and select alternative options if resynchronization is incomplete.
Does LBBAP-CRT with confirmed conduction system capture improve LV systolic function and reduce QRS duration in heart failure patients with LVEF <35% and LBBB?
Observational (n=52)
No
Does LBBAP-CRT with confirmed conduction system capture improve LV systolic function and reduce QRS duration in heart failure patients with LVEF <35% and LBBB?
LBBAP-CRT with confirmed conduction system capture significantly reduces QRS duration and improves LV systolic function in patients with HFrEF and LBBB.
LV systolic improvement after LBBAP-CRT may support further study; leaves open need for randomized confirmation.
Left bundle branch area pacing (LBBAP) positively impacts left ventricular (LV) function in heart failure patients with left bundle branch block. Previous studies showed that proof of condcution system capture leads to more effective results and implanters should carefully evaluate this moment and select alternative options in case of incomplete resynchronization (LOT-CRT, biventricular CRT). We present data from single-center prospective observational study, dedicated for LBBAP-CRT with mandatory confirmation of LBBA capture. Methods: 52 patients with LV EF<35% and LBBB. Inclusion criteria - transition-based LBBA capture and correction of LBBB with only 1 lead. 22 patients - crossovered to LOT-CRT. 30 patients were scheduled for 3,6 and 12 months. Results: Mean age 57,8 ± 13,25 years. 10 (33%) ischemic and 20 (67%) non-Ischemic CMP patients. Baseline QRS duration, EDV, ESV, EF, global longitudinal strain were assesed uring follow-up. LBBAP-CRT resulted in significant reduction of QRS duration after implantation (from 177,37 ± 33,3 ms to 109,71 ± 20,83 ms after final optimisation of AV delay). Systolic function of LV was improved in 92% of all patients. Conclusion: LBBAP is a promising option with potnential advantages over conventional biventricular pacing. Confirmation of conduction system capture is mandatory for heart failure patients. However we need more randomised studies in this field.
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Turubayev et al. (2026) conducted an observational in Heart failure with left bundle branch block (n=52). Left bundle branch area pacing (LBBAP-CRT) was evaluated on QRS duration and left ventricular systolic function. Left bundle branch area pacing significantly reduced QRS duration from 177.4 ms to 109.7 ms and improved left ventricular systolic function in 92% of patients.
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