Heart failure & cardiomyopathiesResearch article
Electrophysiological predictors of super-response to left bundle branch area pacing in nonischemic cardiomyopathy: The PRECISION left bundle branch area pacing (LBBAP) study
- matched comparison of super-responders and partial responders to LBBAP using noninvasive electrocardiographic imaging
Authors' conclusion
Super-response to CRT via LBBAP was associated with greater reductions in ventricular dyssynchrony. The presence of definitive LBB capture emerged as a strong predictor of super-response, emphasizing the mechanistic relevance of conduction system engagement for optimizing CRT outcomes.
Study context
- Population
- Patients with nonischemic cardiomyopathy and left bundle branch (LBB) block (QRS >130 ms) who underwent LBBAPsuper-responders 10 · partial responders 10
- Participants
- 10 vs 10
- Comparison
- super-responders compared with partial responders
- super-respondersn = 10
- partial respondersn = 10
Main finding
Reduction in LVtat
Mean difference
15.2 ms
95% CI 3.4–27.1
P = 0.015
super-responders vs partial responders
mean difference 15.2 ms (95% CI 3.4–27.1); P = 0.015
As reported in the abstract
Further findings
Reduction in biventricular total activation time
P = 0.045
| Outcome | super-responders | partial responders | P value |
|---|---|---|---|
| Ventricular electrical uncoupling improvement | 55.7% (IQR 39.0–67.0) | 5.8% (IQR −18.0–35.5) | P = 0.014 |
| Reduction in LVtat, LBB capture vs LV septal capture | P < 0.001 |
- Reduction in LVtat, LBB capture vs LV septal capture: Confirmed LBB capture 33.2 ± 10.4 ms
- Reduction in LVtat, LBB capture vs LV septal capture: LV septal capture 13.1 ± 9.9 ms
LVtat reduction of ≥26.86% predicting LBB capture
- area under the curve
- 0.96
- sensitivity
- 83%
- specificity
- 100%
Super-response with confirmed LBB capture
- higher odds of super-response
- 7.4-fold
- Bayesian regression
Original publication
Electrophysiological predictors of super-response to left bundle branch area pacing in nonischemic cardiomyopathy: The PRECISION LBBAP study. Heart Rhythm. Published 23 March 2026. doi:10.1016/j.hrthm.2026.03.1908
Summarised from the published abstract; every number is checked against it