Study Comparing Left Bundle Branch Pacing and Conventional Biventricular Pacing Using 2D Strain Echocardiography to Assess Heart Function Improvement in Patients Needing Cardiac Resynchronization Therapy

What this Trial Is About

Researchers are investigating patients who need an implantable device for cardiac resynchronization therapy CRT due to heart failure with reduced ejection fraction HFrEF. This study focuses on whether a specific mechanical activation pattern seen on 2D strain echocardiography before implantation is linked to better acute improvement in heart muscle function. The study compares two types of pacing methods left bundle branch pacing LBBp and conventional biventricular pacing BiVp. Participants will receive either a left bundle branch lead implanted via a sheath for LBB pacing or a conventional CRT device implanted through a vein in the coronary sinus for biventricular pacing. The presence or absence of the typical left bundle branch block LBBB mechanical activation pattern will be documented using 2D strain echocardiography. The study will compare immediate improvements in global work efficiency GWE after implantation between these two pacing methods and between patients with typical and atypical LBBB patterns. During the study, participants will be monitored in the acute phase, mainly within the first two days after device implantation. Researchers will assess myocardial function using ultrasound imaging and calculate measures like GWE to evaluate cardiac response. They will also track procedure and fluoroscopy times, success rates of LBB pacing, and any complications related to pacemaker implantation. The study aims to better understand which patients may benefit most from each pacing method, with participation lasting through the immediate post-implantation period and follow-up as described.

Correlation of Typical LBBB Mechanical Activation Pattern by 2D Strain Echocardiography With Acute GWE Improvement in Patients Receiving LBBp or Conventional BiVp for Cardiac Resynchronization Therapy (Echo LBBp)