PMID- 38367889
OWN - NLM
STAT- Publisher
LR  - 20240404
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Linking)
DP  - 2024 Feb 15
TI  - Efficacy of left bundle branch area pacing versus biventricular pacing in 
      patients treated with cardiac resynchronization therapy: Select site - cohort 
      study.
LID - S1547-5271(24)00195-4 [pii]
LID - 10.1016/j.hrthm.2024.02.024 [doi]
AB  - BACKGROUND: Cardiac resynchronization therapy (CRT) is typically attempted with 
      biventricular (BiV) pacing. One-third of patients are nonresponders. Left bundle 
      branch area pacing (LBBAP) has been evaluated as an alternative means. OBJECTIVE: 
      The purpose of this study was to assess the feasibility and clinical response of 
      permanent LBBAP as an alternative to BiV pacing. METHODS: Of 479 consecutive 
      patients referred with heart failure, 50 with BiV-CRT and 51 with LBBAP-CRT were 
      included in this analysis after study exclusions. Quality-of-Life (QoL) 
      assessments, echocardiographic measurements, and New York Heart Association 
      (NYHA) class were obtained at baseline and at 6-monthly intervals. RESULTS: There 
      were no differences in baseline characteristics between groups (all P > .05). 
      Clinical outcomes such as left ventricular ejection fraction, left ventricular 
      end-systolic volume, QoL, and NYHA class were significantly improved for both 
      pacing groups compared to baseline. The LBBAP-CRT group showed greater 
      improvement in left ventricular ejection fraction at 6 months (P = .001) and 12 
      months (P = .021), accompanied by greater reduction in left ventricular 
      end-systolic volume (P = .007). QRS duration < 120 ms (baseline 160.82 +/- 21.35 ms 
      vs 161.08 +/- 24.48 ms) was achieved in 30% in the BiV-CRT group vs 71% in the 
      LBBAP-CRT group (P </= .001). Improvement in NYHA class (P = .031) and QoL index 
      was greater (P = .014). Reduced heart failure admissions (P = .003) and health 
      care utilization (P < .05) and improved lead performance (P < .001) were observed 
      in the LBBAP-CRT group. CONCLUSION: LBBAP-CRT is feasible and effective CRT. It 
      results into a meaningful improvement in QoL and reduction in health care 
      utilization. This can be offered as an alternative to BiV-CRT or potentially as 
      first-line therapy.
CI  - Copyright (c) 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights 
      reserved.
FAU - Shroff, Jenish P
AU  - Shroff JP
AD  - School of Medicine and Psychology, Australian National University, Australian 
      Capital Territory, Australia; Canberra Heart Rhythm, Australian Capital 
      Territory, Australia.
FAU - Chandh Raja, Deep
AU  - Chandh Raja D
AD  - School of Medicine and Psychology, Australian National University, Australian 
      Capital Territory, Australia.
FAU - Tuan, Lukah Q
AU  - Tuan LQ
AD  - School of Medicine and Psychology, Australian National University, Australian 
      Capital Territory, Australia; Canberra Heart Rhythm, Australian Capital 
      Territory, Australia.
FAU - Abhilash, Sreevilasam P
AU  - Abhilash SP
AD  - Canberra Heart Rhythm, Australian Capital Territory, Australia.
FAU - Mehta, Abhinav
AU  - Mehta A
AD  - School of Medicine and Psychology, Australian National University, Australian 
      Capital Territory, Australia.
FAU - Abhayaratna, Walter P
AU  - Abhayaratna WP
AD  - School of Medicine and Psychology, Australian National University, Australian 
      Capital Territory, Australia.
FAU - Sanders, Prashanthan
AU  - Sanders P
AD  - Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide 
      Hospital, Adelaide, Australia.
FAU - Pathak, Rajeev K
AU  - Pathak RK
AD  - School of Medicine and Psychology, Australian National University, Australian 
      Capital Territory, Australia; Canberra Heart Rhythm, Australian Capital 
      Territory, Australia. Electronic address: 
      rajeev.pathak@canberraheartrhythm.com.au.
LA  - eng
PT  - Journal Article
DEP - 20240215
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
OTO - NOTNLM
OT  - Biventricular pacing
OT  - Cardiac resynchronization therapy
OT  - Heart failure
OT  - Left bundle branch area pacing
OT  - Left bundle branch block
COIS- Disclosures Dr Pathak reports having served on the advisory board of Medtronic, 
      Abbott, Boston Scientific, and Biotronik. Dr Pathak reports that Canberra Heart 
      Rhythm Foundation/Australian National University has received on his behalf 
      lecture and/or consulting fees and research funding from Medtronic, Abbott 
      Medical, Boston Scientific, and Biotronik. Dr Sanders reports having served on 
      the advisory board of Medtronic, Abbott Medical, Boston Scientific, CathRx, and 
      PaceMate. Dr Sanders reports that the University of Adelaide has received on his 
      behalf lecture/consulting fees and/or research funding from Medtronic, Abbott 
      Medical, Boston Scientific, and MicroPort. All other authors have no disclosures.
EDAT- 2024/02/18 00:42
MHDA- 2024/02/18 00:42
CRDT- 2024/02/17 19:17
PHST- 2023/10/15 00:00 [received]
PHST- 2024/02/09 00:00 [revised]
PHST- 2024/02/10 00:00 [accepted]
PHST- 2024/02/18 00:42 [pubmed]
PHST- 2024/02/18 00:42 [medline]
PHST- 2024/02/17 19:17 [entrez]
AID - S1547-5271(24)00195-4 [pii]
AID - 10.1016/j.hrthm.2024.02.024 [doi]
PST - aheadofprint
SO  - Heart Rhythm. 2024 Feb 15:S1547-5271(24)00195-4. doi: 
      10.1016/j.hrthm.2024.02.024.