Why the study?
LBBAP may be an alternative to BVP for CRT, but its acute hemodynamic and ECG effects compared to BVP and LOT-CRT in advanced conduction disease needed evaluation.
Does LOT-CRT or BVP improve acute hemodynamics compared to LBBAP in CRT candidates with advanced conduction disease?
Population
48 CRT candidates with nonspecific interventricular conduction delay (n=29) or LBBB (n=19)
Comparison
BVP vs LBBAP vs LOT-CRT
Design
Multicenter acute hemodynamic testing study
Key result
In CRT candidates with advanced conduction disease, LOT-CRT and BVP provided greater acute increases in LV dP/dt max (25.8% and 26.4%) compared to unipolar LBBAP (19.3%; P≤0.005).
Authors
Loading...
Suggests LOT-CRT or BVP for better acute response in CRT candidates with conduction disease; hypothesis-generating pending randomized outcome trials.
Does LOT-CRT or BVP improve acute hemodynamics compared to LBBAP in CRT candidates with advanced conduction disease?
Absolute Event Rate: 25.8% vs 19.3%
p-value: p=≤0.005
In CRT candidates with advanced conduction disease, LOT-CRT and BVP provide greater acute hemodynamic benefit and QRS shortening than LBBAP alone.
Jastrzębski et al. (2024) studied Advanced conduction disease in CRT candidates (n=48). Left bundle-optimized therapy CRT (LOT-CRT) and biventricular pacing (BVP) vs. Left bundle branch area pacing (LBBAP) was evaluated on Change in left ventricular pressure maximal first derivative (LV dP/dt max) from baseline atrial pacing (p=≤0.005). In CRT candidates with advanced conduction disease, LOT-CRT and BVP provided greater acute increases in LV dP/dt max (25.8% and 26.4%) compared to unipolar LBBAP (19.3%; P≤0.005).