Conduction System vs Biventricular Pacing in Heart Failure

Is conduction system pacing (CSP) noninferior to biventricular pacing (BiVP) for patients with heart failure with reduced ejection fraction (HFrEF) and left bundle-branch block (LBBB)?In this randomized clinical trial of 173 patients across 14 sites in Brazil, CSP was inferior to BiVP for a hierarchical composite of all-cause death, heart failure hospitalizations, urgent heart failure visits, and change in left ventricular ejection fraction at 12 months.These findings do not support the routine use of CSP as the first-line cardiac resynchronization strategy in patients with HFrEF and LBBB.

Corresponding Authors: Carisi A. Polanczyk, MD, PhD (carisi.polanczyk@hmv.org.br), and Andre d’Avila, MD, PhD (adavila@bidmc.harvard.edu), Cardiology Division, Hospital Moinhos de Vento, 910 R. Ramiro Barcelos, Porto Alegre, RS 90035-001, Brazil.

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