Cardiac resynchronization therapy via left bundle branch area pacing and a dual-chamber ICD; a CROSS-LEFT substudy

Abstract Funding Acknowledgements Type of funding sources: None. Background Left bundle branch area pacing (LBBAP) has emerged as a promising technique to deliver cardiac resynchronization therapy (CRT). Purpose We sought evaluate the feasibility single LBBAP lead connected dual-chamber ICD in patients indicated with CRT-D implantation. Methods The CROSS-LEFT study prospectively included consecutive sinus rhythm reduced ejection fraction and complete left block. A DF-1 was implanted at right ventricular apex, an through interventricular septum. Patients were defibrillator (ICD) atrial (RA port), (RV IS-1 defibrillation pin being capped. Atrioventricular delay optimized ensure fusion between native conduction from bundle. followed during 6 months. Results total 22 (median age 68 years, 77% male, 41% ischemic). resulted significant reduction median QRS width 161 128ms (p<0.0001). At months, sensing 18mV (range 5–31, IQR 9), threshold 0.5V 0.25–0.75, 0). Median LVEF significantly improved 27 45% months (p<0.0001), LV end-systolic volume 32% (p=0.0002), 67% considered super-responders. Conclusion In block biventricular defibrillator, CRT can be safely efficiently performed via ICD, is associated electromechanical reverse remodeling.