Left bundle branch-optimized cardiac resynchronization therapy (LOT-CRT): results from an international LBBAP collaborative study group
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F22%3A43921822" target="_blank" >RIV/00064173:_____/22:43921822 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11120/22:43921822
Result on the web
<a href="https://doi.org/10.1016/j.hrthm.2021.07.057" target="_blank" >https://doi.org/10.1016/j.hrthm.2021.07.057</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.hrthm.2021.07.057" target="_blank" >10.1016/j.hrthm.2021.07.057</a>
Alternative languages
Result language
angličtina
Original language name
Left bundle branch-optimized cardiac resynchronization therapy (LOT-CRT): results from an international LBBAP collaborative study group
Original language description
BACKGROUND: Cardiac resynchronization therapy (CRT) based on the conventional biventricular pacing (BiV-CRT) technique sometimes results in broad QRS and suboptimal response. OBJECTIVE: We aimed to assess the feasibility and outcomes of CRT based on left bundle branch area pacing (LBBAP, in lieu of right ventricular lead) combined with coronary venous (CV) left ventricular pacing in an international multicenter study. METHODS: LBBAP-optimized CRT (LOT-CRT) was attempted in non-consecutive patients with CRT indications. Addition of LBBA (or CV) lead was at the discretion of the implanting physician, guided by suboptimal paced QRS and/or on clinical grounds. RESULTS: LOT-CRT was successful in 91/112 (81%) patients. Baseline characteristics: age 70+-11 years, female 20%, LVEF 28.7+-9.8%, LVEDD 62+-9 mm, NT-pro-BNP 5821+-8193 pg/ml, LBBB 42%, NIVCD 22%, RVP 23%, RBBB 12%. Procedure characteristics: mean fluoroscopy 27.3+-22 min, LBBAP capture threshold 0.8+-0.5V @0.5ms, R-wave amplitude 10 mV. LOT-CRT resulted in significantly greater narrowing of QRS from 182+-25 ms at baseline to 144+-22 ms (p<0.0001), compared to BiV-CRT (170+-30 ms, p < 0.0001) and LBBAP (162+-23 ms, p < 0.0001). At follow-up of >= 3 months, EF improved to 37+-12%, LVEDD decreased to 59+-9 mm, NT-pro-BNP decreased to 2514+-3537 pg/ml, pacing parameters were stable, and clinical improvement was noted in 76% of patients (NYHA class 2.9 vs 1.9). CONCLUSION: LOT-CRT is feasible, safe and provides greater electrical resynchronization compared to BiV-CRT and could be an alternative option, especially when only suboptimal electrical resynchronization is obtained with BiV-CRT. Randomized, controlled trials comparing LOT-CRT and BiV-CRT are needed.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
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Continuities
N - Vyzkumna aktivita podporovana z neverejnych zdroju
Others
Publication year
2022
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Heart Rhythm
ISSN
1547-5271
e-ISSN
1556-3871
Volume of the periodical
19
Issue of the periodical within the volume
1
Country of publishing house
US - UNITED STATES
Number of pages
9
Pages from-to
13-21
UT code for WoS article
000741175100008
EID of the result in the Scopus database
2-s2.0-85113308687