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Updated: Sep 28, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

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

10.6K

Cardiac resynchronization therapy in non-ischemic cardiomyopathy: a comparative non-randomized study of His Bundle

Pablo Moriña-Vázquez1, María Teresa Moraleda-Salas2, Adrián Rodríguez-Albarrán3

  • 1Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramon Jimenez (HJRJ)), Ronda Exterior Norte s/n. 21005, Huelva, Spain.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|March 30, 2022
PubMed

Insights

Permanent His bundle pacing cardiac resynchronization therapy (pHBP-CRT) significantly improved left ventricular ejection fraction (LVEF) more than classic biventricular pacing CRT. Pacing thresholds were similar between the two CRT methods.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Cardiac resynchronization therapy (CRT) is crucial for heart failure management.
  • Permanent His bundle pacing (pHBP) is an emerging CRT technique.
  • Limited comparative data exists between pHBP-CRT and classic biventricular pacing (BVP).

Purpose of the Study:

  • To compare the efficacy of pHBP-CRT versus classic CRT in improving left ventricular ejection fraction (LVEF).
  • To evaluate pacing thresholds and QRS duration in both CRT modalities.

Main Methods:

  • Single-center study comparing prospective pHBP-CRT (52 patients) with historical classic CRT (51 patients).
  • Included patients with non-ischemic cardiomyopathy, LVEF < 35%, and left bundle branch block (LBBB).

Main Results:

  • pHBP-CRT demonstrated superior LVEF improvement compared to classic CRT (median 55% vs. 40% at follow-up, p=0.001).
  • Pacing thresholds were similar between pHBP-CRT and classic CRT (p=0.48).
  • Median paced QRS duration was comparable between groups (135 ms vs. 140 ms, p=0.586).

Conclusions:

  • pHBP-CRT offers superior LVEF improvement over classic CRT.
  • Both pacing techniques show similar long-term thresholds and QRS narrowing.
  • pHBP-CRT is a promising alternative for CRT.
Abstract

Keywords:
Cardiac resynchronization therapyHeart failureHis bundle pacingLeft bundle branch block

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