Heart failure & cardiomyopathiesRandomised controlled trial
Left bundle branch area vs biventricular pacing for cardiac resynchronization therapy: the LEFT-BUNDLE-CRT trial
- Randomised controlled trial
- multicentre
- investigator-initiated
- non-inferiority
Authors' conclusion
In CRT candidates with typical LBBB, LBBAP-CRT was not shown to be non-inferior to BiVP-CRT.
Study context
- Population
- Patients with guideline-based cardiac resynchronization therapy (CRT) indications and LBBB per Strauss criteria26 [14.9%] crossovers
- Participants
- 176 patients
- Comparison
- LBBAP-CRT vs BiVP-CRT
- LBBAP-CRTn = 92
- BiVP-CRTn = 84reference
- Primary endpoint
- Positive CRT response: improved clinical composite score (CCS) or ≥15% reduction in LV end-systolic volume
- Follow-up
- 6 months
Primary result
As reported in the abstract
Relative risk
0.95
95% CI 0.88–1.02
By group
LBBAP-CRT vs BiVP-CRT
RR 0.95 (95% CI 0.88–1.02)
Non-inferiority margin 10 as printed, not drawn
Secondary outcomes
CCS improved
≥15% reduction in LV end-systolic volume
Safety
Adverse events and HF hospitalization
- Similar between groups
Original publication
Left bundle branch area vs biventricular pacing for cardiac resynchronization therapy: the LEFT-BUNDLE-CRT trial. Eur Heart J. Published 14 April 2026. doi:10.1093/eurheartj/ehag225
Summarised from the published abstract; every number is checked against it