This global, multicenter registry included 2,579 CRT recipients with LVEF ≤ 50% who underwent either LBBAP or conventional biventricular pacing (BVP), with 780 matched pairs analyzed. Over a mean follow-up of 34 ± 15 months, LBBAP significantly reduced the combined endpoint of all-cause death or first heart failure hospitalization (22.2% vs 30.8%; HR 0.81; P≈0.048), largely driven by fewer HF hospitalizations (13.6% vs 20.8%; HR 0.63; P<0.001). Patients in the LBBAP arm also experienced shorter paced QRS duration (129 vs 143 ms) and fewer procedural complications (3.5% vs 6.5%; P=0.004). Mortality rates were similar between groups, reinforcing LBBAP's safety and potential efficacy for CRT in this patient population.

Join host Michael S. Lloyd, MD, FHRS and guests Hakeem Ayinde, MD, FHRS, and Prashant Bhave, MD, FHRS for this discussion, recorded at Heart Rhythm 2025 in San Diego, California.

• Compare initial cardiac resynchronization therapy using left bundle branch area pacing (LBBAP) with conventional biventricular pacing (BiVp) in 371 patients.

Article Authors

Juan Carlos Diaz, William H. Sauer, Mauricio Duque, Bruce A. Koplan, Eric D. Braunstein, Jorge Eduardo Marín, Julian Aristizabal, Cesar Daniel Niño, Oriana Bastidas, Juan Manuel Martinez, Carolina Hoyos, Carlos D. Matos, Nestor Lopez-Cabanillas, Nathaniel A. Steiger, Sunil Kapur, Thomas M. Tadros, David T. Martin, Paul C. Zei, Usha B. Tedrow, and Jorge E. Romero

Podcast Contributors

Michael S. Lloyd, MD, FHRS, Emory University
Hakeem Ayinde, MD, FHRS, Cardiology Associates of Fredericksburg 
Prashant Bhave, MD, FHRS, Wake Forest School of Medicine  

All relevant financial relationships have been mitigated.

Host Disclosure(s):

M. Lloyd:
Honoraria/Speaking/Consulting: Medtronic, Arga Medtech, Circa Scientific
Membership on Advisory Committees: Boston Scientific

​Contributor Disclosure(s):

H. Ayinde:
Honoraria/Speaking/Consulting: Johnson and Johnson

P. Bhave:
Honoraria/Speaking/Consulting: American Collge of Cardiology, Boston Scientific, Abbott Medical
 

Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):
S. Sailor: No relevant financial relationships with ineligible companies to disclose.
S. Colbert: No relevant financial relationships with ineligible companies to disclose.