Heart failure & cardiomyopathies
Conduction system pacing compared with biventricular pacing for cardiac resynchronization therapy in patients with heart failure and mildly reduced left ventricular ejection fraction: Results from International Collaborative LBBAP Study (I-CLAS) Group
Main finding · Death or HFHResult — go to the resultHazard ratio 0.64 95% CI 0.43–0.94Authors' conclusion
CSP was associated with improved clinical outcomes compared with BVP in this large cohort of patients with HFmrEF undergoing CRT.
Study context
- Population
- Patients with heart failure with mildly reduced ejection fraction (HFmrEF) (left ventricular ejection fraction (LVEF) 36%-50%) undergoing cardiac resynchronization therapy (CRT), January 2018 to June 2023
- Participants
- 1,004 patients
- Exposure
- Conduction system pacing (CSP) vs biventricular pacing (BVP) for CRT
- CSPn = 826
- BVPn = 178reference
- Outcome
- Composite of:
- Time to death
- HF hospitalization (heart failure hospitalization (HFH))
Methodological detailsmulticentre, 16 international centres, consecutive patients
- Multicentre
- 16 international centres
- Consecutive patients
Main finding
Death or HFH
Hazard ratio
0.64
95% CI 0.43–0.94
P = 0.025
By group
CSP vs BVP
HR 0.64 (95% CI 0.43–0.94); P = 0.025
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Paced QRS duration · significantly narrower with CSP
P < 0.001
| Outcome | CSP | BVP | P value |
|---|---|---|---|
| LVEF during follow-up | 49% (SD 10%) | 48% (SD 10%) | P = 0.32 |
LVEF during follow-up
- LVEF improved in both groups
Original publication
Conduction system pacing compared with biventricular pacing for cardiac resynchronization therapy in patients with heart failure and mildly reduced left ventricular ejection fraction: Results from International Collaborative LBBAP Study (I-CLAS) Group. Heart Rhythm. Published 27 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it