His-pacing and biventricular pacing show similar efficiency in resynchronization and improvements in longitudinal contractile function

Abstract Background The clinical role for HIS-pacing in cardiac resynchronization therapy (HIS-CRT) is promising but yet to be established. randomised His-alternative study showed better remodelling with HIS-CRT compared patients receiving conventional biventricular pacing (BIV-CRT) the per-protocol-analysis. Purpose In this substudy we investigated whether was more efficient BIV-CRT improving mechanical synchrony and longitudinal contractile function. Methods His-Alternative 50 symptomatic heart failure, left ventricular ejection fraction (LVEF) ≤35% Left bundle branch block were randomized 1:1 His-CRT or BiV-CRT followed 6 months. At implantation, 7 crossed over from His-pacing LV-pacing group 1 patient group. All had echocardiography performed including 2D-strain asses global systolic deformation (GLS) at baseline Mechanical dyssynchrony measured as SD of time-to-peak all 12 segments ventricle (TPS-SD). Results There no significant differences characteristics between regard strain. LVEF significantly higher months (48±8% vs. 42±8%; p<0.05) However, GLS did not improve BIV-CRT, (−8.7ms ± 2.0 −11.1 ms vs −9.1 2.7 −10.8±2.5 2.8, P = ns difference) regarding TPS-SD there difference either (110 51 47 10 115 42 60 21, difference). Conclusion substudy, prove than resynchronizing ventricle, nor observed improvement function differ methods. number included rather small larger studies are needed fully assess possible benefits HIS-CRT. Funding Acknowledgement Type funding sources: None.