Heart failure & cardiomyopathiesRandomised controlled trial
Conduction system pacing versus biventricular pacing for cardiac resynchronization: the CSP-SYNC randomized single center study
- Randomised controlled trial
- non-inferiority
- single-centre
- investigator-initiated
Authors' conclusion
In patients with a Class I indication for CRT, LBBAP was non-inferior to BiV pacing in improving LVEF and provided similar structural and electrical remodelling.
Study context
- Population
- Patients with Class I indication for cardiac resynchronization therapy (CRT)
- Participants
- 62 patients
- Comparison
- Left bundle branch area pacing (LBBAP) vs biventricular (BiV) pacing for CRT
- LBBAPn = 31
- BiVn = 31reference
- Primary endpoint
- Change in left ventricular ejection fraction (LVEF)
- Follow-up
- 6 months
Primary result
As reported in the abstract
Mean intergroup difference
5.6 %
95% CI 1.6–9.5
P < 0.001 for non-inferiority
By group
LBBAP vs BiV
mean intergroup difference 5.6 % (95% CI 1.6–9.5); P for non-inferiority < 0.001
Secondary outcomes
mL
| Outcome | LBBAP | BiV | mean difference (mL) (95% CI) | P value | |
|---|---|---|---|---|---|
| Change in LVESV | −64 (95% CI −78–-50) | −40 (95% CI −54–-25) | −24 (−44 to −4) | P for non-inferiority < 0.001 | |
| −60−40−20020Difference, mL (linear scale) |
Change in 6-min walk test and NYHA class
- 6-min walk test change, non-inferiority
- P < 0.001
- NYHA class change, non-inferiority
- P = 0.011
Temporal trends of LV remodelling and HF hospitalization rates
- Comparable between groups
Original publication
Conduction system pacing versus biventricular pacing for cardiac resynchronization: the CSP-SYNC randomized single center study. Europace. Published 23 August 2025. doi:10.1093/europace/euaf192
Summarised from the published abstract; every number is checked against it