Left bundle branch pacing-CRT better for patients with heart failure and LVEF
China: In heart failure patients with nonischemic cardiomyopathy and left bundle branch block (LBBB), left bundle branch pacing (LBBP) cardiac resynchronization therapy (CRT) shows more significant improvement in left ventricular ejection fraction (LVEF) than biventricular pacing (BiVP), states a recent study. The Journal of the American College of Cardiology (JACC) mentioned the study.
Left bundle branch pacing, a most rapidly growing conduction system pacing technique, is capable of correcting intrinsic left bundle branch block. It could be an optimal alternative to CRT with biventricular pacing. Yao Wang, Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, China, and colleagues aimed to compare the effectiveness of LBBP-CRT with BiVP-CRT in patients with heart failure reduced left ventricular ejection fraction (LVEF) in a prospective, randomized trial.
The trial included patients with nonischemic cardiomyopathy and LBBB having a 6-month preplanned follow-up. In case of failure of LBBP or BiVP, crossovers were allowed.
The difference in LVEF improvement between the two groups was the primary endpoint. The secondary endpoints were changes in N-terminal pro–B-type natriuretic peptide (NT-proBNP), echocardiographic measurements, 6-minute walk distance, New York Heart Association functional class, CRT response, and QRS duration. A total of 40 consecutive patients comprising 20 males (mean age 63.7 years, LVEF 29.7% ± 5.6%) were included in the study.
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