The Lead Episode 163: A Discussion of Conduction System vs Biventricular Pacing in Heart Failure, The PhysioSync-HF Randomized Clinical Trial-The Lead Episode 163 Bonus Video File

Video Transcription

Video Summary

This podcast reviewed the PhysioSync Heart Failure randomized trial comparing biventricular pacing with conduction system pacing (mainly left bundle branch area pacing) in 173 heart failure patients with reduced ejection fraction and wide QRS. The trial, conducted across multiple centers in Brazil, found conduction system pacing did not meet non-inferiority and was inferior on a composite endpoint including death, heart failure hospitalization, urgent visits, and ejection fraction improvement. Speakers highlighted limitations such as small sample size, short follow-up, and operator learning curve, especially when true conduction capture was not always achieved. Current practice remains guideline-based, favoring biventricular pacing first.

Keywords

PhysioSync Heart Failure trial

biventricular pacing

conduction system pacing

left bundle branch area pacing

heart failure reduced ejection fraction