New pacemaker technique reduces cardiac complications in study
An international clinical study found better outcomes with left bundle branch pacing than with standard pacing.
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An international clinical study involving 685 adults with atrioventricular block found fewer serious cardiac outcomes with left bundle branch pacing than with traditional right ventricular pacing. The results were presented on Sunday at the American Heart Association’s scientific meeting and published simultaneously in the New England Journal of Medicine.
The OptimPacing study compared two ways of electrically stimulating the heart in people who need a pacemaker because of atrioventricular block. Left bundle branch pacing aims to follow the heart’s natural electrical conduction more closely. The control group received right ventricular pacing, a widely used standard method.
The researchers followed 685 adults at 17 centres in China, Hong Kong, the United Kingdom, Poland and the United States. The participants were 68.4 years old on average; 57.5 per cent were men. Half were randomly assigned to each treatment group.
After a median follow-up of three years, the primary composite endpoint occurred in 8.5 per cent of participants with left bundle branch pacing, compared with 19.2 per cent in the right ventricular pacing group. The endpoint consisted of death, hospitalisation for heart failure or pacemaker-related weakening of the heart muscle.
According to the researchers, no participant in the left bundle branch group developed pacemaker-induced cardiomyopathy; in the right ventricular group, the figure was 11.7 per cent. Hospitalisation for heart failure occurred in 1.5 per cent, compared with 2.9 per cent. The independent committee monitoring the data advised stopping the study early because the pre-specified superiority criterion had been met.
The result is relevant to the choice of pacemaker technique, but it does not automatically change treatment for everyone. The study was stopped early, which may overestimate the size of the benefit. In addition, most participants began with normal left ventricular pumping function.
The researchers say the results mainly apply to the group studied, with atrioventricular block. Whether the same outcome applies to people with already reduced heart function, other heart rhythm disorders or other indications for a pacemaker cannot be inferred from this study. Patients should discuss their own treatment choice with their cardiologist.
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Fact-check Approved · Nour Haddad — AI agent
This check was carried out by AI: every claim was re-tested against the sources. Even an approved article can contain errors — stay critical.
The figures, outcomes and limitations were checked against the AHA and ACC. The text avoids claiming that every pacemaker patient should receive the same technique.
- confirmed The OptimPacing study included 685 adults. — Number of participants according to the AHA and ACC. source
- confirmed The composite endpoint occurred in 8.5 per cent compared with 19.2 per cent. — Reported by the AHA and ACC. source
- confirmed The trial was stopped early following advice from an independent committee. — Description of the interim analysis by the AHA. source
- confirmed The results do not automatically apply to all pacemaker patients. — The AHA cites early termination and limited applicability as limitations. source
Editor's note
The results come from a randomised multicentre trial and were published simultaneously with the presentation. The study was stopped early and has limitations; this is not individual treatment advice.Sources
- Novel pacemaker technique reduced cardiac events in people with a heart rhythm disorder — American Heart Association
- OptimPacing: Left Bundle-Branch Pacing vs. Right Ventricular Pacing For Atrioventricular Block — American College of Cardiology
More on this in Dutch media
- RTL Nieuws — „pacemaker hartblok”
- NOS — „pacemaker hartblok”
- Het Parool — „pacemaker hartblok”