Heart failure & cardiomyopathies
Relationship of different left bundle branch pacing sites and clinical outcomes in patients with heart failure
Authors' conclusion
Different left bundle branch capture sites led to a subtle difference in mechanical synchrony, which may, in turn, affect LVEF improvement in patients with heart failure.
Study context
- Population
- Patients with HF referred for successful left bundle branch pacing (LBBP) implantation
- Participants
- 43 patients
- Exposure
- LBTP vs left posterior fascicular pacing vs left anterior fascicular pacing
- Outcome
- Response to LBBP (echocardiographic and ECG)
- Follow-up
- 6-month follow-up
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Response rate · 6 months
Observational data: associations, not effects.
Further findings
| Outcome | LBTP | P value |
|---|---|---|
| Peak LV activation time and V1/V2 intrinsicoid deflection to QRS end; septal strain and lateral-septal loading inhomogeneityLBTP vs Left fascicular pacing · intrinsicoid deflection V1/V2 to QRS end | P＜.0001 | |
| Peak LV activation time | 76.5 ± 10.2 ms | P = 0.037 |
| Intrinsicoid deflection in V1 or V2 to QRS end | 128.0 ± 6.0 ms | |
| Peak LV activation time and V1/V2 intrinsicoid deflection to QRS end; septal strain and lateral-septal loading inhomogeneityLBTP vs Left fascicular pacing · better improvement in septal systolic longitudinal strain | P = 0.007 | |
| Peak LV activation time and V1/V2 intrinsicoid deflection to QRS end; septal strain and lateral-septal loading inhomogeneityLBTP vs Left fascicular pacing | P = 0.036 |
- Peak LV activation time and V1/V2 intrinsicoid deflection to QRS end; septal strain and lateral-septal loading inhomogeneity: Left fascicular pacing Peak LV activation time 82.3 ± 6.5 ms · Intrinsicoid deflection in V1 or V2 to QRS end 113.3 ± 5.2 ms
- Peak LV activation time and V1/V2 intrinsicoid deflection to QRS end; septal strain and lateral-septal loading inhomogeneity: better improvement in lateral-septal myocardial loading inhomogeneity
Association of LBB capture site with improvement in peak strain dispersion and LVEF (linear regression)
- Peak strain dispersion: model R2 = 0.586
- P = 0.042
- LVEF: model R2 = 0.425
- P < 0.0001
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Relationship of different left bundle branch pacing sites and clinical outcomes in patients with heart failure. Heart Rhythm. Published 2 September 2024. doi:10.
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