Heart failure & cardiomyopathiesTrial design
Direct His/LBB pacing as an alternative to biventricular pacing in patients with HFrEF and a typical left bundle branch block (LBBB): Design and rationale for the His-Alternative II trial
- investigator-initiated, multicenter, randomized non-inferiority trial
- 1:2 randomization ratio
- design and rationale
Study context
- Population
- Patients with symptomatic heart failure (New York Heart Association class II to III), left ventricular ejection fraction ≤35%, strict LBBB by electrocardiographic criteria, and optimal medical therapypatients randomized
- Participants
- 150 patients
- Planned comparison
- BiV-CRT vs conduction system pacing (CSP)-based cardiac resynchronization therapy (CRT)
- Primary endpoint
- Change in left ventricular end-systolic volume assessed by echocardiography
- Follow-up
- 6 months
No results yet. This paper sets out the design of a trial; its results are to come.
Original publication
Direct His/LBB pacing as an alternative to biventricular pacing in patients with HFrEF and a typical LBBB: Design and rationale for the His-Alternative II trial. Am Heart J. Published 20 May 2026. doi:10.1016/j.ahj.2026.107491
Summarised from the published abstract; every number is checked against it