Heart failure & cardiomyopathies
An in silico guide for ventriculo-ventricular delay programming for left bundle branch-optimized cardiac resynchronization therapy
Authors' conclusion
The optimal VVD for LOT-CRT depends on the mechanism of delayed LV activation and type of capture achieved, highlighting the importance of VVD optimization.
Study context
- Population
- Simulated ventricular activation on 24 anatomies with diffuse left ventricular (LV) conduction system delay or intra-myocardial delay, with or without proximal left bundle branch block (LBBB)
- Participants
- 24 anatomies
- Comparison
- Ventriculo-ventricular delay (VVD) settings for LOT-CRT across LV conduction substrates
- Outcome
- Optimal VVD for LOT-CRT (shortest 95% LV activation time, LV activation times (LVAT95))
Methodological detailsin silico, validated against clinical data
- In silico
- Validated against clinical data
Main finding
As reported in the abstract
Optimal VVD for LOT-CRT
Diffuse LV conduction system delay with LBBB: optimal VVD (always negative, left bundle branch pacing (LBBP) ahead)
−42.5 ± 6.6 ms
Diffuse LV conduction system delay without LBBB: optimal VVD (always negative, LBBP ahead)
−36.2 ± 5.6 ms
LV intra-myocardial disease with LBBB: optimal VVD (coronary sinus LV first)
23.3 ± 8.5 ms
LV intra-myocardial disease without LBBB: optimal VVD (coronary sinus LV first)
79.2 ± 18.0 ms
Original publication
An in silico guide for ventriculo-ventricular delay programming for left bundle branch-optimized cardiac resynchronization therapy. Europace. Published 21 May 2025. doi:10.
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