Heart failure & cardiomyopathiesCohort study
Comparison of Left Bundle Branch Area Pacing and Biventricular Pacing in Candidates for Resynchronization Therapy
- Observational cohort study
- multicentre
- 15 international centres
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
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:10.1016/j.jacc.2023.05.006
Summarised from the published abstract; every number is checked against it