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.

https://www.hrsonline.org/education/TheLead
https://www.heartrhythmjournal.com/article/S1547-5271%2825%2902312-4/abstract?utm

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