Heart failure & cardiomyopathies

Sex-Specific Outcomes of Left Bundle Branch Area Pacing (LBBAP) Versus Biventricular Pacing: Results From I-CLAS

JACC Clin ElectrophysiolPublished Multicentre cohort study

Main finding · Death or HFH, womenResult — go to the resultHazard ratio 0.64 95% CI 0.43–0.97

Authors' conclusion

Women obtained significantly greater reductions in the combined endpoint of death or HFH (primarily driven by reduction in HFH) with LBBAP compared with BVP among patients requiring CRT than did men.

Study context

Population
Patients undergoing cardiac resynchronization therapy (CRT) (575 female, 1203 male)575 female, 1203 male
Participants
1,778 patients
Exposure
LBBAP-CRT vs BVP-CRT, by sex
Outcome
Death or HF hospitalisation (heart failure hospitalization (HFH))
Methodological detailsinternational, sex-specific survival analysis
  • International
  • Sex-specific survival analysis

Main finding

Death or HFH, women

Hazard ratio

0.64

95% CI 0.43–0.97

P = 0.03

LBBAPvs BVP
HR 0.64 (95% CI 0.43–0.97); P = 0.03

As reported in the abstract

Observational data: associations, not effects.

Secondary outcomes

OutcomeHR (95% CI)P value
HFH alone, women60% reduction0.4 (0.24–0.69)P < 0.01
Death or HFH, women, by subgroupLBBAPvs BVPNonischemic cardiomyopathy0.45 (0.26–0.79)P < 0.01
Death or HFH, women, by subgroupLBBAPvs BVPLBBB0.49 (0.27–0.87)P < 0.01

Echocardiographic outcomes

Sex-specific echocardiographic outcomes better in women than men

Original publication

Sex-Specific Outcomes of LBBAP Versus Biventricular Pacing: Results From I-CLAS. JACC Clin Electrophysiol. Published 3 September 2023. doi:10.1016/j.jacep.2023.08.026

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