Key result
Propagation discontinuity artifacts identified by epicardial mapping predicted successful resynchronization by His bundle pacing in patients with LBBB (log OR 2.19; 95% CI 0.07-4.31; p=0.04).
Why the study?
It was unknown whether ventricular activation times and patterns achieved by HBP match intact conduction systems, and not all patients with LBBB achieve resynchronization with HBP.
Does His bundle pacing improve ventricular resynchronization compared to biventricular pacing in patients with LBBB and LV impairment?
Observational (n=45)
Does His bundle pacing improve ventricular resynchronization compared to biventricular pacing in patients with LBBB and LV impairment?
Odds Ratio: 2.19 (95% CI 0.07–4.31)
p-value: p=0.04
Noninvasive electrocardiographic mapping can identify LBBB patients who may achieve maximum potential ventricular resynchronization with His bundle pacing.
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His-CRT may restore more physiological activation than BVP; leaves open whether this improves outcomes in LBBB.
Arnold et al. (2020) conducted an observational in Heart failure and left bundle branch block (LBBB) (n=45). His bundle pacing (HBP) vs. Biventricular pacing (BVP) and normal conduction was evaluated on Successful resynchronization achieved by HBP predicted by propagation discontinuity artifacts (logarithmic OR 2.19, 95% CI 0.07-4.31, p=0.04). Propagation discontinuity artifacts identified by epicardial mapping predicted successful resynchronization by His bundle pacing in patients with LBBB (log OR 2.19; 95% CI 0.07-4.31; p=0.04).