Cost-Utility Analysis of Left Bundle Branch Area Versus Biventricular Pacing for Cardiac Resynchronization Therapy: A
José M Sánchez-Moreno1,2,3, Leticia García-Mochón1,3,4,5, Manuel Molina-Lerma2,3
1Universidad de Granada, Granada, Spain.
Journal of Cardiovascular Electrophysiology
|November 30, 2025
Summary
Left bundle branch area pacing cardiac resynchronization therapy (LBBAP CRT) offers similar clinical and quality-adjusted life year (QALY) outcomes to biventricular pacing CRT (BVP CRT). LBBAP CRT may provide significant cost savings per patient.
Area of Science:
- Cardiology
- Health Economics
- Medical Technology
Background:
- Cardiac resynchronization therapy (CRT) is standard for heart failure (HF).
- Left bundle branch area pacing (LBBAP) presents a more physiological alternative to biventricular pacing (BVP) for CRT.
- The study evaluates the cost-utility of LBBAP CRT versus BVP CRT.
Purpose of the Study:
- To compare the cost-utility of LBBAP CRT against BVP CRT.
- To assess clinical outcomes and quality-adjusted life years (QALYs) between the two CRT methods.
- To determine the economic efficiency of LBBAP CRT in heart failure management.
Main Methods:
- A prospective, multicenter, quasi-experimental study involving 62 patients undergoing CRT.
- Patients received either LBBAP CRT or BVP CRT across four referral centers.
- Cost-utility analysis focused on implant costs, 12-month follow-up events, and EQ-5D-5L measured QALYs.
Main Results:
- Clinical outcomes were comparable between LBBAP CRT and BVP CRT groups.
- LBBAP CRT demonstrated an average cost saving of €2391.02 per patient compared to BVP CRT.
- An incremental gain of 0.07 QALYs was observed with LBBAP CRT, though not statistically significant across all confidence intervals.
Conclusions:
- LBBAP CRT is a potentially cost-efficient alternative for cardiac resynchronization.
- Similar clinical and QALY outcomes support LBBAP CRT adoption.
- Significant cost savings per patient suggest LBBAP CRT as a favorable option for healthcare systems.
