Conduction system versus biventricular pacing in heart failure with non‐left bundle branch block

摘要

Abstract Introduction The benefits of cardiac resynchronization therapy (CRT) with biventricular pacing (BiV) is significantly lower when applied to heart failure (HF) patients with non‐left bundle branch block (LBBB) conduction delay. We investigated clinical outcomes of conduction system pacing (CSP) for CRT in non‐LBBB HF. Methods Consecutive HF patients with non‐LBBB conduction delay undergoing CSP were propensity matched for age, sex, HF‐etiology, and atrial fibrillation (AF) in a 1:1 ratio to BiV from a prospective registry of CRT recipients. Echocardiographic response was defined as an increase in left ventricular ejection fraction (LVEF) by ≥10. The primary outcome was the composite of HF‐hospitalizations or all‐cause mortality. Results A total of 96 patients were recruited (mean age 70?±?11years, 22 female, 68 ischemic HF and 49 AF). Significant reductions in QRS duration and LV dimensions were seen only after CSP, while LVEF improved significantly in both groups (p?