Heart failure & cardiomyopathiesRandomised controlled trial
Long-Term Outcomes of Left Bundle-Branch Pacing vs Biventricular Pacing in Heart Failure
- Randomised controlled trial
- multicentre
- prospective
Authors' conclusion
In this study, LBBP was superior to BiVP in reducing the risk of death or HFH in patients with LBBB and severely reduced LVEF.
Study context
- Population
- HF patients with left bundle-branch block (LBBB) and left ventricular ejection fraction (LVEF) ≤35%, 6 centres in China
- Participants
- 200 patients
- Comparison
- Left bundle-branch pacing (LBBP) vs biventricular pacing (BiVP)
- Primary endpoint
- Time to all-cause death or HF hospitalization (HFH)
Primary result
Death or HFH · median follow-up 36 months
Hazard ratio
0.26
95% CI 0.12–0.57
P < 0.001
By group
LBBP vs BiVP
HR 0.26 (95% CI 0.12–0.57); P < 0.001
As reported in the abstract
Secondary outcomes
All-cause mortality
- No significant difference in all-cause mortality (LBBP vs BiVP)
- 2.0% vs 5.0%; HR, 0.40; 95% CI, 0.08-2.04; P = .25
Heart failure hospitalization (HFH)
- LBBP significantly reduced the risk of HFH (LBBP vs BiVP)
- 7.0% vs 28.0%; HR, 0.23; 95% CI, 0.10-0.52; P < .001
Echocardiographic response (absolute LVEF increase ≥5%)
- Similar in both groups (LBBP vs BiVP)
- 86.0% vs 81.0%; P = .34
Super response (absolute LVEF increase ≥15% or LVEF improved to ≥50%)
- Super-response rate higher with LBBP (LBBP vs BiVP)
- 55.0% vs 36.0%; P < .007
Original publication
Long-Term Outcomes of Left Bundle-Branch Pacing vs Biventricular Pacing in Heart Failure. JAMA Cardiol. Published 1 April 2026. doi:10.1001/jamacardio.2026.0083
Summarised from the published abstract; every number is checked against it