Related Experiment Video

Updated: May 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

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Cardiac resynchronization therapy via left bundle branch pacing in heart failure with complete left bundle branch

Dandan Yang1,2, Qunchao Ma1,2, Hong Zhu1

  • 1Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Frontiers in Cardiovascular Medicine
|January 30, 2025
PubMed

Insights

Dual-chamber left bundle branch pacing (LBBP) significantly improved heart function in patients with complete left bundle branch block (CLBBB) and heart failure. This therapy offers an alternative to CRT-D, potentially avoiding ICD implantation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Complete left bundle branch block (CLBBB) in heart failure patients often necessitates cardiac resynchronization therapy (CRT-D).
  • Left bundle branch pacing (LBBP) is an emerging technique for pacing the left ventricle.
  • Investigating LBBP as an alternative to CRT-D for specific heart failure populations is crucial.

Purpose of the Study:

  • To evaluate the efficacy of dual-chamber LBBP as an alternative to CRT-D in heart failure patients with CLBBB.
  • To assess the impact of LBBP on left ventricular ejection fraction (LVEF) and intraventricular synchrony.
  • To identify patient subgroups who may benefit from LBBP and avoid implantable cardioverter-defibrillator (ICD) implantation.

Main Methods:

  • Retrospective cohort study including 34 heart failure patients with CLBBB and CRT-D indications.
  • Inclusion criteria: LVEF < 35%, NYHA class II-IV, CLBBB (Strauss criteria), intraventricular dyssynchrony.
  • Exclusion criteria: Ischemic cardiomyopathy, significant LGE on CMR, secondary prevention ICD indications.

Main Results:

  • LBBP significantly improved LVEF from 31.1% to 61.0% (P < 0.001).
  • All patients achieved a super-response, with LVEF > 50%.
  • Intraventricular dyssynchrony markers, SPWMD and SDI, significantly decreased post-LBBP (P < 0.001).

Conclusions:

  • Dual-chamber LBBP is an effective alternative therapy for selected heart failure patients with CLBBB.
  • LBBP can achieve significant improvement in cardiac function and synchrony.
  • Patients meeting specific criteria may avoid ICD implantation by opting for LBBP.
Abstract

Keywords:
cardiac resynchronization therapyheart failureimplantable cardioverter defibrillatorleft bundle branch blockleft bundle branch pacing

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