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July 31, 2026Expert Review of Medical Devices

LBBP cuts all-cause mortality ~43% and heart failure hospitalizations vs BVP in CRT patients.

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Why the study?

The study was conducted to compare the efficacy and safety of left bundle branch pacing versus biventricular pacing in patients with heart failure undergoing cardiac resynchronization therapy.

Does left bundle branch pacing improve clinical, structural, and electrical outcomes compared to biventricular pacing in heart failure patients undergoing cardiac resynchronization therapy?

Comparison

LBBP vs BVP

Design

Systematic review and meta-analysis of RCTs and cohort studies

Key result

Left bundle branch pacing lowered all-cause mortality (OR 0.57; 95% CI 0.48-0.68) and heart failure hospitalization compared to biventricular pacing in heart failure patients undergoing CRT.

Authors

MJMuhammad Asad JahangirAHAhmad HassanAMAffaf Mahmood

Discussion

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Overview

LBBP may improve CRT outcomes versus BVP in HF; extends RCT data in updated meta-analysis.

Key Points

  • This research aims to compare the efficacy and safety of left bundle branch pacing (LBBP) to biventricular pacing (BVP) in heart failure patients undergoing cardiac resynchronization therapy (CRT).
  • Conducted an updated systematic review and meta-analysis.
  • Included randomized controlled trials and cohort studies from PubMed, Cochrane Library, ScienceDirect, and Embase up to February 2026.
  • Assessed risk of bias using RoB 2.0 and ROBINS-I; pooled data as odds ratios (OR) or mean differences (MD).
  • LBBP reduced fluoroscopy time by MD -7.00 (95% CI -9.99 to -4.01) and procedural duration by MD -23.62 (95% CI -35.29 to -11.95).
  • LBBP improved CRT response (OR 1.85, 95% CI 1.06–3.23) and super-response (OR 1.56, 95% CI 1.38–1.77).
  • LBBP lowered all-cause mortality (OR 0.57, 95% CI 0.48 to 0.68) and heart failure hospitalization (OR 0.50, 95% CI 0.43 to 0.57).

Study Design

Type

Meta-Analysis (n=9,278)

Structured PICO

Does left bundle branch pacing improve clinical, structural, and electrical outcomes compared to biventricular pacing in heart failure patients undergoing cardiac resynchronization therapy?

P
Population
9,278 patients with heart failure undergoing cardiac resynchronization therapy across 24 randomized and observational studies.
I
Intervention
Left bundle branch pacing (LBBP)
C
Comparator
Biventricular pacing (BVP)
O
Outcome
Efficacy and safety (including all-cause mortality, heart failure hospitalization, CRT response, QRS duration, LVEF, and procedural metrics)hard clinical

Main Result

Odds Ratio: 0.57 (95% CI 0.48–0.68)

In patients with heart failure undergoing CRT, left bundle branch pacing is associated with improved electrical, structural, and clinical outcomes, including reduced mortality and heart failure hospitalization, compared to traditional biventricular pacing.

Cite This Study

Jahangir et al. (2026) conducted a meta-analysis in heart failure (n=9,278). Left bundle branch pacing (LBBP) vs. Biventricular pacing (BVP) was evaluated on all-cause mortality (OR 0.57, 95% CI 0.48 to 0.68). Left bundle branch pacing lowered all-cause mortality (OR 0.57; 95% CI 0.48-0.68) and heart failure hospitalization compared to biventricular pacing in heart failure patients undergoing CRT.

synapsesocial.com/papers/6a6c477c747664a1aa73cf3ehttps://doi.org/10.1080/17434440.2026.2711869
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