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Updated: Jun 30, 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

10.5K

Long-term efficacy of left bundle branch pacing and biventricular pacing in patients with heart failure complicated

Jia Li1, Hongwei Yi1, Jun Han1

  • 1Department of Cardiology, Wuhan Asian Heart Hospital, Wuhan, Hubei, China.

Frontiers in Cardiovascular Medicine
|March 15, 2024
PubMed

Insights

Left bundle branch pacing (LBBP) offers superior outcomes compared to biventricular pacing (BiVP) for patients with heart failure and complete left bundle branch block. LBBP demonstrated significant improvements in left ventricular function and echocardiographic response rates.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Resynchronization Therapy

Background:

  • Left bundle branch pacing (LBBP) is an emerging physiological pacing technique for complete left bundle branch block (CLBBB).
  • LBBP is considered a promising alternative to biventricular pacing (BiVP) for cardiac resynchronization therapy (CRT).

Purpose of the Study:

  • To compare the efficacy of LBBP versus BiVP in patients suffering from heart failure (HF) complicated with CLBBB.
  • To evaluate the impact of LBBP and BiVP on left ventricular function, dimensions, and response rates.

Main Methods:

  • A retrospective, single-center study included 120 patients with HF and CLBBB undergoing CRT.
  • Patients were divided into LBBP (n=60) and BiVP (n=60) groups.
  • Primary endpoints included changes in left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and echocardiographic response rate; secondary endpoints included mortality, hospitalization, and procedural parameters.

Main Results:

  • The LBBP group showed a significantly greater increase in absolute LVEF (14.8% vs. 10.7%, P=0.02) and a more significant reduction in LVEDD (P=0.03) compared to the BiVP group.
  • LBBP achieved a higher echocardiographic super-response rate (65% vs. 45%, P=0.02).
  • LBBP demonstrated superior pacing parameters, including shorter paced QRS duration (P=0.002), lower pacing threshold (P<0.001), and shorter procedural duration (P=0.04).

Conclusions:

  • LBBP is more effective than BiVP in improving left ventricular function and echocardiographic response in patients with HF and CLBBB.
  • LBBP offers significant advantages in pacing efficiency and procedural characteristics over BiVP.
  • LBBP is a superior pacing strategy for non-ischemic cardiomyopathy patients with HF, CLBBB, and LVEF ≤ 35%.
Abstract

Keywords:
biventricular pacingcardiac resynchronization therapy (CRT)heart failureleft bundle branch block (LBBB)left bundle branch pacing

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