His Corrective Pacing or Biventricular Pacing for Cardiac Resynchronization in Heart Failure

• Published in: Journal of the American College of Cardiology 2019-07, Vol.74 (1), p.157-159
• Main Authors: Upadhyay, Gaurav A., Vijayaraman, Pugazhendhi, Nayak, Hemal M., Verma, Nishant, Dandamudi, Gopi, Sharma, Parikshit S., Saleem, Moeen, Mandrola, John, Genovese, Davide, Tung, Roderick
• Format: Article
• Language: English
• Subjects: Aged; Bundle of His - physiopathology; Bundling; Cardiac Resynchronization Therapy - methods; Cardiology; Cardiovascular disease; Clinical trials; Coronary artery; Coronary artery disease; Electrocardiography; Feasibility studies; Female; Heart; Heart failure; Heart Failure - physiopathology; Heart Failure - therapy; His bundle; Humans; Male; Middle Aged; Patients; Prospective Studies; Randomization; Single-Blind Method; Ventricle
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2019.04.026

The frequency in which His bundle pacing can correct left bundle branch block patterns in an unselected heart failure population is not known, and no prospective trials comparing BiV-CRT versus His bundle pacing in lieu of a left ventricular lead for CRT (His-CRT) have been performed to date. The His-SYNC (His Bundle Pacing versus Coronary Sinus Pacing for Cardiac Resynchronization Therapy) pilot trial was an investigator-initiated, prospective, randomized controlled trial that aimed to assess the feasibility and efficacy of His-CRT as a first-line strategy compared with BiV-CRT. Among 41 patients enrolled (64 ± 13 years of age, 38% women, LVEF 28%, 65% with coronary artery disease, QRS width 168 ± 18 ms [left bundle branch block pattern = 35, right bundle branch block = 2, paced = 3]), 21 were randomized to His-CRT and 20 to BiV-CRT.