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Related Experiment Video

Updated: May 12, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Biventricular pacing for atrioventricular block and systolic dysfunction.

Anne B Curtis¹, Seth J Worley, Philip B Adamson

¹Department of Medicine, University at Buffalo, Buffalo General Medical Center, 100 High St., D2-76, Buffalo, NY 14203, USA. abcurtis@buffalo.edu

The New England Journal of Medicine

|April 26, 2013

Summary

Biventricular pacing significantly reduced mortality and heart failure events in patients with atrioventricular block and systolic dysfunction compared to standard right ventricular pacing.

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Area of Science:

Cardiology
Electrophysiology
Heart Failure Management

Background:

Right ventricular apical pacing can lead to left ventricular systolic dysfunction.
Biventricular pacing is an alternative strategy for patients with atrioventricular block.

Purpose of the Study:

To evaluate if biventricular pacing reduces mortality, morbidity, and adverse left ventricular remodeling.
To compare biventricular pacing with standard right ventricular pacing in specific patient populations.

Main Methods:

Patients with atrioventricular block, NYHA class I-III heart failure, and LVEF ≤50% were enrolled.
Participants were randomized to receive either standard right ventricular pacing or biventricular pacing via a cardiac-resynchronization device.
The primary outcome measured was time to death, urgent heart failure visit, or significant increase in left ventricular end-systolic volume index.

Main Results:

Biventricular pacing resulted in a significantly lower incidence of the primary outcome compared to right ventricular pacing (HR, 0.74; 95% CI, 0.60-0.90).
The primary outcome occurred in 45.8% of patients with biventricular pacing versus 55.6% with right ventricular pacing.
Left ventricular lead complications were reported in 6.4% of patients.

Conclusions:

Biventricular pacing demonstrates superiority over conventional right ventricular pacing.
This approach is beneficial for patients with atrioventricular block and left ventricular systolic dysfunction (NYHA class I-III).