Left bundle-branch pacing lowered composite cardiac events in OptimPacing trial

The international randomized OptimPacing trial found left bundle-branch pacing superior to right ventricular pacing for patients with atrioventricular block who needed a pacemaker and had a high ventricular pacing burden. The results were presented at the American Heart Association’s Scientific Sessions and published in the New England Journal of Medicine. MedPage Today reported that the trial stopped early for superiority, after an interim analysis at 35.1 months.

Among 685 patients, the estimated 4-year rate of the combined outcome of death, heart failure hospitalization or pacing-induced cardiomyopathy was 8.5% with left bundle-branch pacing and 19.2% with right ventricular pacing, MedPage Today reported. No patients in the left bundle-branch pacing group developed pacing-induced cardiomyopathy, compared with 11.7% in the right ventricular pacing group. The reports note that early termination could overestimate the benefit, and that most participants had normal heart pumping strength at the start of the trial.