{"id":"33f07bf70c78","type":"article","url":"https://hartvaat.nl/2022/09/27/linkerbundeltakpacing-versus-biventriculaire-pacing-voor-crt-gerandomiseerde-tri/","title":"Linkerbundeltakpacing versus biventriculaire pacing voor CRT: gerandomiseerde trial","title_en":"Randomized Trial of Left Bundle Branch vs Biventricular Pacing for Cardiac Resynchronization Therapy.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["cardiale-resynchronisatie","linkerbundeltakpacing","summit-trial"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2022.07.019","source_url":"https://doi.org/10.1016/j.jacc.2022.07.019","authors":["Yao Wang","Haojie Zhu","Xiaofeng Hou","Zhao Wang","Fengwei Zou","Zhiyong Qian","Yongyue Wei","Xiang Wang","Longyao Zhang","Xiaofei Li","Zhimin Liu","Siyuan Xue","Chaotong Qin","Jiaxin Zeng","Hui Li","Hongping Wu","Hong Ma","Kenneth A Ellenbogen","Michael R Gold","Xiaohan Fan","Jiangang Zou"],"significance":8,"published":"2022-09-27","source_date":"2022-09-27","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/crt-cardiale-resynchronisatietherapie/"],"congress":"","summary_en":"This first randomized trial comparing left bundle branch area pacing with biventricular pacing for cardiac resynchronization therapy showed that LBBP achieved comparable or superior echocardiographic response with a simpler implantation procedure. The results positioned LBBP as a viable CRT alternative.","created":"2026-07-03T10:29:57Z","updated":"2026-07-03T13:29:04Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Eerste gerandomiseerde trial die linkerbundeltakpacing (LBBP) vergeleek met biventriculaire pacing voor cardiale resynchronisatietherapie. LBBP was non-inferieur en toonde vergelijkbare echocardiografische respons met een eenvoudigere implantatieprocedure.","abstract_original":"BACKGROUND: Left bundle branch pacing (LBBP) is the most rapidly growing conduction system pacing technique that is capable of correcting intrinsic left bundle branch block (LBBB). As such, it is potentially an optimal alternative to cardiac resynchronization therapy (CRT) with biventricular pacing (BiVP). OBJECTIVES: The authors sought to compare the efficacy of LBBP-CRT with BiVP-CRT in patients with heart failure and reduced left ventricular ejection fraction (LVEF). METHODS: This is a prospective, randomized trial of patients with nonischemic cardiomyopathy and LBBB with 6-month preplanned follow-up. Crossovers were allowed if LBBP or BiVP were unsuccessful. The primary endpoint was the difference in LVEF improvement between 2 groups. The secondary endpoints included changes in echocardiographic measurements, N-terminal pro-B-type natriuretic peptide (NT-proBNP), New York Heart Association functional class, 6-minute walk distance, QRS duration, and CRT response. RESULTS: The study included 40 consecutive patients (20 males, mean age 63.7 years, LVEF 29.7% ± 5.6%). Crossovers occurred in 10% of LBBP-CRT and 20% of BiVP-CRT. All patients completed follow-up. Intention-to-treat analysis showed significantly higher LVEF improvement at 6 months after LBBP-CRT than BiVP-CRT (mean difference: 5.6%; 95% CI: 0.3-10.9; P = 0.039). LBBP-CRT also appeared to have greater reductions in left ventricular end-systolic volume (-24.97 mL; 95% CI: -49.58 to -0.36 mL) and NT-proBNP (-1,071.80 pg/mL; 95% CI: -2,099.40 to -44.20 pg/mL), and comparable changes in New York Heart Association functional class, 6-minute walk distance, QRS duration, and rates of CRT response compared with BiVP-CRT. CONCLUSIONS: LBBP-CRT demonstrated greater LVEF improvement than BiVP-CRT in heart failure patients with nonischemic cardiomyopathy and LBBB. (Left Bundle Branch Pacing Versus Biventricular Pacing for Cardiac Resynchronization Therapy [LBBP-RESYNC]; NCT04110431)."}