Heart failure & cardiomyopathiesRandomised controlled trial
Targeted left ventricular lead placement in biventricular pacing for heart failure: a national, multicentre, double-blind, randomised controlled trial in Denmark
- Randomised controlled trial
- double-blind
- superiority
- national
- multicentre (5 Danish university centres)
- block randomisation
Authors' conclusion
In patients with heart failure and prolonged QRS, targeted left ventricular lead placement at the site of latest electrical activation did not reduce the composite endpoint of death or unplanned hospitalisation for heart failure compared with conventional lead placement in a posterolateral, non-apical position.
Study context
- Population
- Patients with HF and wide QRS on guideline-directed medication, eligible for biventricular pacing1,000 in modified ITT analysis
- Participants
- 1,001 patients
- Comparison
- Intervention vs Control
- Interventionn = 499
- Controln = 502reference
- Primary endpoint
- Composite of:
- Time to death
- First unplanned HF hospitalisation
Primary result
As reported in the abstract
median 45.8 months
Hazard ratio
1.10
95% CI 0.86–1.39
P = 0.45
Events by treatment group
Intervention vs Control
HR 1.10 (95% CI 0.86–1.39); P = 0.45
Further findings
| Outcome | mean difference (milliseconds) (95% CI) | |
|---|---|---|
| Electrical activation at LV lead (later in intervention) | 9 (5–13) | |
| −1001020Difference, milliseconds (linear scale) |
Safety
Overall complications
- Overall complications — Procedure-related deaths in intervention
- 1
Overall complications
- Lead-related complications more frequent in intervention
Original publication
Targeted left ventricular lead placement in biventricular pacing for heart failure: a national, multicentre, double-blind, randomised controlled trial in Denmark. Lancet. Published 31 August 2026. doi:10.1016/s0140-6736(26)01597-7
Summarised from the published abstract; every number is checked against it