Left bundle branch area pacing optimized cardiac resynchronization therapy (LOT CRT) -comparative results to a CRT implanted patient population

Cardiac resynchronization therapy (CRT) is gold standard treatment option among patients with symptomatic heart failure with reduced left ventricular ejection fraction (LVEF) and intraventricular conduction delay of left bundle branch block (LBBB) morphology.

Left bundle branch area pacing optimized cardiac resynchronization therapy (LOT CRT) is a novel and promising approach for CRT candidate patients even in advanced intraventricular conduction delay, however convincing follow-up data regarding this patient group is still lacking.

In our observational registry 35 LOT CRT vs. 35 conventional CRT patients were consecutively implanted according to current guidelines. All the patients had LBBB morphology QRS width of >150 ms. The two compared patient group did not show significant difference in age, gender, baseline non-ischemic etiology, LVEF, NYHA functional class, LBBB QRS width.

Immediate postoperative results showed significantly increased QRS width reduction (p=.028) and at 6 months of follow-up a significantly greater improvement in LVEF(p=.031), NYHA functional class (p=.04) and Nt-ProBNP levels (p=0.043) were seen in LOT CRT patient group compared to conventional CRT patients.

Our single center observational study showed significant improvement in prompt postoperative QRS width and clinical follow-up parameters in LOT CRT implanted patients compared to conventional CRT implanted patients.

LOTCRTvs.CRTQRSwidthreduction