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Updated: Jul 12, 2026
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
Using Cornell Product to Predict Echocardiographic Response of Left Bundle Branch Area Pacing
Selda Murat1, Gurbet Özge Mert1, Fatih Enes Durmaz2
1Department of Cardiology, Eskişehir Osmangazi University, Eskişehir, Türkiye.
Objective:
Cardiac resynchronization therapy with left bundle branch area pacing (LBBAP) is a novel resynchronization technique that serves as an alternative to biventricular pacing. This study investigated the predictive value of electrocardiographic Cornell Product (CP) in identifying super-responders to LBBAP among heart failure patients with left bundle branch block (LBBB).
Method:
This retrospective study included 32 patients who underwent LBBAP, had a left ventricular ejection fraction (LVEF) ≤ 35%, were in sinus rhythm with LBBB and a QRS duration ≥ 150 ms, and had been receiving optimal medical therapy for at least three months. CP was calculated from baseline 12-lead electrocardiography (ECG) using the following formula: CP (mm x ms) = [(RaVL + SV3) x QRS duration]. Super-response was defined as an increase of at least 15% in LVEF six months after the procedure. Patients were classified as super-responders or non-super-responders, and their clinical, electrocardiographic, and echocardiographic parameters were compared.
Results:
Among the 32 patients, 53% (n = 17) were identified as super-responders. The mean age of participants was 65.2 +- 9.9 years, and 46.9% were female. Based on baseline 12-lead ECG, CP was significantly lower in the super-responder group (3788.4 [3222.4-4569.6] mm*ms vs. 5174.0 [4516.4-5296.0] mm*ms, P = 0.044). Additionally, multivariate analysis revealed that systolic pulmonary artery pressure (odds ratio [OR]: 1.08; P = 0.041) and CP (OR: 1.01; P = 0.036) were independent predictors of super-response to LBBAP.
Conclusion:
CP, a simple and readily applicable electrocardiographic parameter, can serve as a predictor of which patients will benefit from LBBAP.
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