Heart failure & cardiomyopathies
LVSP and Left Bundle Branch Pacing (LBBP) Result in Similar or Improved Left Ventricular (LV) Synchrony and Hemodynamics Compared to Biventricular Pacing (BVP)
Authors' conclusion
Ultra-high-frequency electrocardiography allowed the documentation of differences in LV synchrony between LBBP, LVSP, and BVP, which were not observed by measuring QRSd. LVSP provided the same LV synchrony and hemodynamic status as BVP, while LBBP was better than BVP in both.
Study context
- Population
- CRT candidates with LV conduction disease (mean LVEF 29%, mean QRS duration (QRSd) 168 ± 24 ms; 13 ischemic cardiomyopathy)
- Participants
- 35 candidates
- Comparison
- LBBP and LVSP vs BVP
- Outcome
- LV electrical dyssynchrony (ultra-high-frequency ECG) and LV haemodynamic status (invasive SBP)
Methodological detailswithin-patient comparison, multiple transitions between pacing modes
- Within-patient comparison
- Multiple transitions between pacing modes
Main finding
As reported in the abstract
LV electrical dyssynchrony and SBP
Each group vs BVPDifference, ms (95% CI)P value
LBBPLV electrical dyssynchrony
−10(−16 to −4)
P = 0.001LVSPLV electrical dyssynchrony
−5(−12 to 1)
P = 0.10Each group vs BVPDifference, % (95% CI)P value
LBBPSBP
4(2%–5%)
P < 0.001LVSPSBP
1(0%–2%)
P = 0.10Further findings
QRSd
- QRSd during BVP, LVSP and LBBP the same
Haemodynamic differences, nonischemic vs ischemic (subgroup)
- Haemodynamic differences of LBBP and LVSP vs BVP more pronounced in nonischemic than ischemic patients
Original publication
LVSP and LBBP Result in Similar or Improved LV Synchrony and Hemodynamics Compared to BVP. JACC Clin Electrophysiol. Published 16 May 2024. doi:10.
Summarised from the published abstract; every number is checked against it