Heart failure & cardiomyopathies
Echocardiographic response from left bundle branch area pacing optimized cardiac resynchronization therapy (LOT-CRT) vs traditional cardiac resynchronization therapy (CRT)
Authors' conclusion
LOT-CRT resulted in superior LVEF and LVESV improvements compared with BVP in NIVCD and LBBB patients and enhanced CRT response.
Study context
- Population
- Patients with conventional CRT indications and left bundle branch block (LBBB) or nonspecific intraventricular conduction delay (NIVCD) (preferentially NIVCD)
- Exposure
- LOT-CRT vs biventricular pacing (BVP)
- LOT-CRTn = 34
- Outcome
- Echocardiographic response: absolute % change in LVEF and relative % change in LVESV
- Follow-up
- 6-month follow-up
Methodological detailsexternal BVP cohort from an independent study
- External BVP cohort from an independent study
Main finding
As reported in the abstract
LVEF improvement and LVESV reduction · 6 months
LOT-CRT
- LV ejection fraction (LVEF) improvement
- 16.1%
- LV end-systolic volume (LVESV) reduction
- −43.5%
BVP
- LVEF improvement
- 6.1%
- LVESV reduction
- −20.9%
LV ejection fraction (LVEF) improvement
LOT-CRT16.1%
BVP6.1%
LV end-systolic volume (LVESV) reduction
LOT-CRT−43.5%
BVP−20.9%
- LVEF improvement, adjusted for baseline characteristics
- difference 7.5%; P < 0.01
- LVESV reduction, adjusted for baseline characteristics
- difference 18.4%; P < 0.01
Observational data: associations, not effects.
Further findings
Response by LBBB and NIVCD subgroups
- Response consistent across LBBB and NIVCD subgroups
LOT-CRT with QRS ≥ 171 ms
- Greater benefit in LVEF and LVESV
- P = 0.04
Successful LOT-CRT vs DOT-CRT
- No significant differences between successful LOT-CRT and DOT-CRT
Original publication
Echocardiographic response from left bundle branch area pacing optimized cardiac resynchronization therapy (LOT-CRT) vs traditional CRT. Heart Rhythm. Published 18 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it