JACC. Asia
October 14, 2026 · via Europe PMC
PCWP Characterizes Responders of Left Bundle Branch Area Pacing in HFpEF Population.
Su Y, Xu X, Xie D, +9 more, Che W
AI summary — for doctors, generated from the abstract only
In HFpEF patients needing pacing, left bundle branch area pacing was associated with fewer heart failure hospitalizations than right ventricular pacing, and greater PCWP reduction marked responders.
What was studied
A cohort study of 201 HFpEF patients with bradycardia (100 RV pacing, 101 LBBAP) compared with right heart catheterization and echocardiography, with a primary composite of HF hospitalization and all-cause mortality.
Key findings
- LBBAP achieved better electrical synchrony with preserved hemodynamics and cardiac mechanics
- The primary endpoint occurred in 21.5% with RVP vs 9.5% with LBBAP (log-rank P = 0.024), driven by fewer HF hospitalizations
- Mean PCWP fell by 4.0 mm Hg with LBBAP vs 2.3 mm Hg with RVP
Clinical relevance
LBBAP may be preferable to RV pacing in HFpEF, and PCWP change could help identify responders.
Who should care
Limitations
The abstract is cut off at the PCWP P value, so that result is incomplete. Non-randomized, relatively short median follow-up of 17.6 months.
LBBAP looked favorable versus RVP in HFpEF, but randomized confirmation is needed.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
BACKGROUND
The hemodynamic and mechanical benefit of left bundle branch area pacing (LBBAP) in heart failure with preserved ejection fraction (HFpEF) remained underexplored.
OBJECTIVES
The authors aimed to evaluate the hemodynamic and mechanical response of LBBAP in HFpEF population.
METHODS
This cohort study includes patients with pacemaker-indicated symptomatic bradycardia and right heart catheterization (RHC) diagnosed HFpEF. Patients are consecutively enrolled from 2 treatment groups: 1 group receives LBBAP only, and the other receives right ventricular pacing (RVP) only. Periprocedural right heart catheterization and echocardiography were evaluated and compared. Primary endpoint was the composite of heart failure hospitalization (HFH) and all-cause mortality.
RESULTS
Two hundred one patients with HFpEF were included, 100 patients from RVP group and 101 patients from LBBAP group. Baseline characteristics were similar. Compared with RVP, LBBAP achieved better electrical synchrony with preserved hemodynamics and cardiac mechanics. With a median of 17.6 (13.5, 22.5) months, LBBAP also presented better survival for the primary endpoint (21.5% for RVP vs 9.5% for LBBAP; log-rank P = 0.024), contributed by reduced HFH incidence. Distinctively, LBBAP resulted in a more significant reduction of mean PCWP (-2.3 [-3.0, 0] mm Hg for RVP vs -4.0 [-4.9, -1.0] mm Hg for LBBAP; P < 0.001). Multivariate Cox model revealed that in the LBBAP group, Δmean PCWP predicted primary endpoint incidence (HR [95% CI]: 1.525 [1.118, 2.080]; P = 0.011).
CONCLUSIONS
In HFpEF population, LBBAP better preserved cardiac function and presented better survival for HFH compared with RVP. Reduction of PCWP might characterize the responders of LBBAP in HFpEF population.
TRIAL REGISTRATION NUMBER
NCT05575557.
DOI
10.1016/j.jacasi.2026.08.030
PMID
42886112
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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