Heart failure & cardiomyopathies
A Comparison of the Association of Septal Scar Burden on Responses to LBBAP-CRT and BVP-CRT
Main finding · LVEF improvement, low septal scar burden (<5.7%)Result — go to the resultOdds ratio 4.35Authors' conclusion
Remodeling response to LBBAP and BVP among nonischemic cardiomyopathy patients is modified by septal scar burden. High septal scar burden was associated with poor clinical prognosis independent of CRT methods.
Study context
- Population
- Patients with nonischemic cardiomyopathy with cardiac resynchronization therapy (CRT) indications and preprocedure CMR
- Participants
- 147 patients
- Exposure
- LBBAP-CRT vs BVP-CRT, by septal scar burden
- Left bundle branch area pacing (LBBAP)n = 51
- Biventricular pacing (BVP)n = 96reference
- Outcome
- Change in LVEF and echocardiographic response (≥5% absolute LVEF increase), by septal scar burden
- Follow-up
- 6 months
Methodological detailspropensity score adjustment
- Propensity score adjustment
Main finding
LVEF improvement, low septal scar burden (<5.7%)
Odds ratio
4.35
P = 0.033
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
Mean
| Outcome | LBBAP | BVP | P value |
|---|---|---|---|
| LVEF improvement, high septal scar burden (≥5.7%) · 6 monthsTrend favouring BVP | 6.4% (SD 12.4%) | 9.2% (SD 9.4%) | P = 0.085 |
Composite of all-cause mortality, HF hospitalization or major ventricular arrhythmia · median follow-up 33.7 (Q1-Q3: 19.8-42.1) months
- Composite outcome occurred in all patients
- 34.7% (n = 51)
- High-burden subgroups had worse clinical outcomes independent of CRT method
Original publication
A Comparison of the Association of Septal Scar Burden on Responses to LBBAP-CRT and BVP-CRT. JACC Clin Electrophysiol. Published 8 May 2024. doi:10.
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