Heart failure & cardiomyopathies
Predictors of failed left bundle branch pacing implant in heart failure with reduced ejection fraction: Importance of left ventricular diameter and QRS morphology
Authors' conclusion
When LBBP was used as CRT, LVEDD and non-LBBB QRS morphology predicted unsuccessful implantation. Non-LBBB triples the likelihood of failed implantation independent of LVEDD.
Study context
- Population
- Consecutive cardiac resynchronization therapy (CRT) candidates with HF undergoing left bundle branch pacing (LBBP)
- Participants
- 187 candidates
- Exposure
- Failed vs successful LBBP implantation
- Failedn = 35
- Successfuln = 152reference
- Outcome
- Predictors of unsuccessful LBBP implantation
Methodological detailsconsecutive patients, Clinical, echocardiographic and ECG variables prospectively recorded
- Consecutive patients
- Clinical, echocardiographic and ECG variables prospectively recorded
Main finding
As reported in the abstract
Independent predictors of unsuccessful LBBP implantation (multivariate)
Odds ratio (95% CI)P value
LVEDD (per 5-mm increase)
1.31(1.05–1.63)
P = 0.02non-LBBB
3.07(1.08–8.72)
P = 0.03Per 5-mm increase, as printed
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| LVEDD of 60 mm for predicting LBBP implant failure | LVEDD 60 mm Sensitivity 60% · Specificity 71% |
Causes of unsuccessful implantation (n = 35)
- Unsatisfactory paced QRS morphology
- 28 of 35 [80%]
- Inability to screw the helix
- 4 of 35 [11.4%]
- Lead instability
- 2 of 35 [5.7%]
- High pacing thresholds
- 1 of 35 [2.8%]
Univariate predictors of failed implantation
- Left ventricular end-diastolic diameter (LVEDD), non-LBBB QRS morphology and QRS width predicted failed implantation
- Univariate analysis
Original publication
Predictors of failed left bundle branch pacing implant in heart failure with reduced ejection fraction: Importance of left ventricular diameter and QRS morphology. Heart Rhythm. Published 19 June 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →