Why the study?
It was unknown whether biventricular pacing at initial implant preserves LV function in patients with milder LV systolic dysfunction and AV block requiring pacing.
Does biventricular pacing reduce the composite of all-cause mortality, urgent heart failure care, or LVESVI increase in patients with AV block and mild-to-moderate LV dysfunction compared to standard right ventricular pacing?
Does biventricular pacing reduce the composite of all-cause mortality, urgent heart failure care, or LVESVI increase in patients with AV block and mild-to-moderate LV dysfunction compared to standard right ventricular pacing?
Hazard Ratio: 0.74 (95% CI 0.6–0.9)
Absolute Event Rate: 45.8% vs 55.6%
p-value: posterior probability of HR = 0.9978
In patients with AV block and LVEF ≤50%, biventricular pacing demonstrated superior long-term clinical and functional outcomes compared to standard right ventricular pacing, prompting expanded FDA indications.
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ElGuindy et al. (2013) conducted a review in Atrioventricular block with mild-to-moderate LV dysfunction (n=691). Biventricular pacing vs. Standard right ventricular pacing was evaluated on Composite of all-cause mortality, urgent heart failure care requiring intravenous diuretics or increase in LV end-systolic volume index (LVESVI) >15% from baseline (HR 0.74, 95% CI 0.60-0.90, p=posterior probability of HR = 0.9978).
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