Heart failure & cardiomyopathies
Effectiveness of upgrading to left bundle branch area pacing compared with biventricular pacing in patients with right ventricular pacing-induced cardiomyopathy
Authors' conclusion
PICM upgrading to LBBAP or BiVP demonstrated similar clinical outcomes, but upgrading to LBBAP was associated with greater improvement in LVEF.
Study context
- Population
- Patients with pacing-induced cardiomyopathy (PICM) who underwent upgrading to either left bundle branch area pacing (LBBAP) or BiVPincluded in the final analysis (33% patients with left ventricular ejection fraction (LVEF) < 35%)
- Participants
- 78 patients
- Exposure
- LBBAP compared with BiVP in patients with PICM
- LBBAPn = 40
- BiVPn = 38
- Left bundle branch pacing (LBBP)n = 30
- Left ventricular septal pacing (LVSP)n = 10
- Outcome
- Change in left ventricular ejection fraction (LVEF) from baseline
- Follow-up
- 6-month follow-up
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
LBBAP
9.59
± 7.48 · %
BiVP
4.91
± 7.73 · %
P = 0.008
Observational data: associations, not effects.
Further findings
| Outcome | LBBAP | BiVP | LBBP | LVSP | Adjusted hazard ratio (CI) | P value | |
|---|---|---|---|---|---|---|---|
| Clinical outcomes (all-cause mortality, heart failure hospitalization, and malignant ventricular arrhythmias) · mean follow-up duration of 20.5 ± 12.5 monthsBiVPvs LBBAPAfter adjustment for confounders | 17.5% | 26.3% | — not stated in the abstract | — not stated in the abstract | 1.57 (0.55–4.48) | P = 0.395 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
— not stated in the abstract
| Outcome | LBBAP | BiVP | LBBP | LVSP |
|---|---|---|---|---|
| LVEF improvement, LBBP vs LVSP (subgroup) · 6-month follow-up | — not stated in the abstract | — not stated in the abstract | 10.62 ± 7.28 % | 6.47 ± 7.57 |
— not stated in the abstract
Original publication
Effectiveness of upgrading to left bundle branch area pacing compared with biventricular pacing in patients with right ventricular pacing-induced cardiomyopathy. Heart Rhythm. Published 22 May 2025. doi:10.
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