Efficacy on resynchronization and longitudinal contractile function comparing His-bundle pacing with conventional...

Area of Science:

• Cardiology
• Electrophysiology
• Heart Failure Management

Background:

• His-bundle pacing (His-CRT) is an emerging technique for cardiac resynchronization therapy (CRT).
• Limited data exist comparing His-CRT with conventional biventricular CRT (BiV-CRT).
• The comparative effects on mechanical dyssynchrony and longitudinal contractile function are unknown.

Purpose of the Study:

• To compare the effects of His-CRT versus BiV-CRT on mechanical dyssynchrony.
• To evaluate the impact of His-CRT versus BiV-CRT on longitudinal contractile function.
• To assess regional and global changes in cardiac function post-implantation.

Main Methods:

• Randomized trial of patients with heart failure, LVEF ≤ 35%, and LBBB.
• Patients randomized to His-CRT or BiV-CRT.
• Two-dimensional strain echocardiography used to assess mechanical dyssynchrony and longitudinal strain at baseline and 6 months.

Main Results:

• Both His-CRT and BiV-CRT significantly reduced mechanical dyssynchrony.
• Global longitudinal strain improved in both His-CRT and BiV-CRT groups.
• No significant differences in the changes of mechanical dyssynchrony or global longitudinal strain were observed between the two groups.

Conclusions:

• In heart failure patients with LBBB, His-CRT and BiV-CRT demonstrate comparable efficacy.
• Both pacing strategies lead to similar improvements in mechanical dyssynchrony.
• Longitudinal contractile function is similarly enhanced by His-CRT and BiV-CRT.