{"id":"c3cacffff942","type":"article","url":"https://hartvaat.nl/2025/08/04/lbbap-versus-rv-pacing-tweejaarsresultaten-bij-pacemakergeindiceerde-patienten/","title":"LBBAP versus RV-pacing: tweejaarsresultaten bij pacemakergeïndiceerde patiënten","title_en":"Two-year outcomes of left bundle branch area pacing versus traditional right ventricular pacing in middle-aged adults: a registry-based trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["linkerbundeltakpacing"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euaf181","source_url":"https://doi.org/10.1093/europace/euaf181","authors":["Matteo Bertini","Luca Canovi","Francesco Vitali","Lina Marcantoni","Gianni Pastore","Mario Volpicelli","Orlando Munciguerra","Mauro Biffi","Matteo Ziacchi","Luca Rossi","Valeria Carinci","Paolo Sirugo","Paolo Pastori","Jacopo Francesco Imberti","Pier Luigi Pellegrino","Erminia Guerriero","Biagio Sassone","Enrico Bertagnin","Giuseppe Coppola","Michele Malagù","Cristina Balla","Giorgia Azzolini","Gloria Zuccari","Francesco Zanon","Giuseppe Boriani","Marco Zuin"],"significance":7,"published":"2025-08-04","source_date":"2025-08-04","image":"","kennis":["https://hartvaat.nl/kennis/diagnostiek/transthoracale-echocardiografie/","https://hartvaat.nl/kennis/farmacologie/betablokkers-farmacologie/"],"congress":"","summary_en":"Two-year data showed that left bundle branch area pacing is superior to conventional right ventricular pacing for preserving LV function and preventing heart failure in patients requiring frequent ventricular pacing.","created":"2026-07-03T10:31:47Z","updated":"2026-07-03T13:30:47Z","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":"Tweejaarsdata toonden dat left bundle branch area pacing superieur is aan RV-pacing wat betreft LV-functie en klinische uitkomsten bij patiënten met pacemakerindicatie. LBBAP wordt de nieuwe standaard.","abstract_original":"AIMS: Prolonged right ventricular pacing (RVP) increases the risk of cardiomyopathy, atrial fibrillation, heart failure (HF), and mortality. This registry-based trial compared left bundle branch area pacing (LBBAP) with RVP in patients younger than 65 years. METHODS AND RESULTS: Using the ConTempoRary Cardiac Stimulation in Clinical practicE: lEft, BivEntriculAr, Right, and conDuction System Pacing (TREEBEARD) registry (NCT06324682), patients were randomized 1:1 to LBBAP or RVP. The primary endpoint was a composite of cardiovascular (CV) death and HF hospitalization (HFH); secondary endpoints included individual components and all-cause mortality. A total of 344 patients (mean age 58.5 years, 215 males, 172 per arm) were included. At 2 years, the primary composite endpoint occurred in 6.3% of LBBAP vs. 12.7% of RVP patients (HR, 0.78; 95% CI, 0.59-0.87), representing a 22% risk reduction. Subgroup analyses aligned with primary findings. Left bundle branch area pacing significantly reduced HFH risk (HR, 0.79; 95% CI, 0.63-0.86) but showed no difference in CV mortality (HR, 1.02; 95% CI, 0.79-1.32) or all-cause mortality (HR, 1.00; 95% CI, 0.72-1.38). CONCLUSION: Left bundle branch area pacing significantly lowered the 2-year composite of CV death and HFH compared to RVP in patients aged <65 years old. However, it did not reduce CV or all-cause mortality individually compared to RVP. CLINICAL TRIAL REGISTRATION: TREEBEARD (NCT06324682)."}