Study Comparing Outcomes of Left Bundle Branch Pacing Versus Conventional Biventricular Pacing in Patients With Chronic Heart Failure and Reduced Heart Pump Function

What this Trial Is About

Heart failure HF is a common and serious condition that increases with age and leads to higher mortality, frequent hospital stays, and reduced quality of life. Cardiac resynchronization therapy CRT using biventricular pacing has helped many patients with reduced left ventricular function and left bundle branch block LBBB, but about 30% do not respond to this treatment. New pacing methods like His bundle pacing HBP and left bundle branch pacing LBBP have been developed, with LBBP showing promising clinical advantages and potentially better outcomes for patients with chronic HF and reduced ejection fraction. This study compares two types of CRT devices one using conventional biventricular pacing and the other using left bundle branch pacing. Both therapies involve implanting a cardioverter-defibrillator with pacing leads placed through veins to the heart. The biventricular pacing device stimulates both ventricles, while the LBBP device targets the left bundle branch directly, aiming for improved heart function. The implantation procedure includes local anesthesia, lead placement, and device programming. The study will observe and compare these two approaches to evaluate their effects on heart remodeling and clinical outcomes. Participants will be monitored for 24 months after implantation. Researchers will assess outcomes such as overall mortality, heart failure worsening requiring hospitalization, ventricular function, exercise tolerance, and quality of life using specific questionnaires. Device performance and heart rhythm events will also be tracked. The study includes detailed evaluations with echocardiography, laboratory tests, and biomarker analysis to understand how each therapy influences heart structure and function. Follow-up visits will ensure safety and effectiveness data are collected throughout the study period.

Conventional Biventricular Versus Left Bundle Branch Pacing on Outcomes in Heart Failure Patients