Heart failure & cardiomyopathies
Comparison of Left Bundle Branch Area Pacing and Biventricular Pacing in Candidates for Resynchronization Therapy
Authors' conclusion
LBBAP improved clinical outcomes compared with BVP in patients with CRT indications
Study context
- Population
- Patients with left ventricular ejection fraction (LVEF) ≤35% undergoing first biventricular pacing (BVP) or left bundle branch area pacing (LBBAP) for Class I or II cardiac resynchronization therapy (CRT) indications, January 2018 to June 2022
- Participants
- 1,778 patients
- Exposure
- LBBAP vs BVP
- LBBAPn = 797
- BVPn = 981reference
- Outcome
- Composite of:
- Time to death
- HF hospitalization
Methodological detailsmulticentre, 15 international centres
- Multicentre
- 15 international centres
Main finding
As reported in the abstract
Hazard ratio
1.495
95% CI 1.213–1.842
P < 0.001
By group
LBBAP vs BVP
HR 1.495 (95% CI 1.213–1.842); P < 0.001
Observational data: associations, not effects.
Secondary outcomes
Paced QRS duration
Baseline LBBAP 161 ± 28 ms
| Outcome | LBBAP | BVP |
|---|---|---|
| LVEF change from baseline after CRT | mean 13% (SD 12%) | mean 10% (SD 12%) |
| LVEF baseline → follow-up | 27% ± 6% to 41% ± 13% (P < 0.001) | 27% ± 7% to 37% ± 12% (P < 0.001) |
- Paced QRS duration: LBBAP vs baseline P < 0.001
- Paced QRS duration: LBBAP vs BVP P < 0.001
- LVEF change from baseline after CRT: greater change with LBBAP P < 0.001
Original publication
Comparison of Left Bundle Branch Area Pacing and Biventricular Pacing in Candidates for Resynchronization Therapy. J Am Coll Cardiol. Published 21 May 2023. doi:10.
Summarised from the published abstract; every number is checked against it