Medtronic Cardiac Rhythm and Heart Failure
This 2x2 randomized crossover feasibility study will evaluate the therapeutic value of adding pacing from the left ventricular lead to Left Bundle Branch Area Pacing (LBBAP) using a cardiac resynchronization therapy defibrillator (CRT-D). This combined therapy is known as Left Bundle Branch Optimized Cardiac Resynchronization Therapy (LOT-CRT) and will be compared to LBBAP therapy over sequential 6-month periods in CRT-indicated patients with LBBB. Primary and secondary outcomes are echocardiographic changes. Exploratory assessments will include NT-proBNP and subject-reported quality of life (KCCQ). An observational treatment arm will include subjects who have not been randomized due to unsuccessful implant for real-world observational analysis
Inclusion Criteria: * Subject meets current ACC/AHA/HRS guidelines for implantation of a CRT-D device. * Subject has documented LVEF ≤ 35% within 60 days of enrollment. * Subject meets the criteria for presence of Strauss-defined LBBB. * Subject meets NYHA classification II or III. * Subject is willing and able to provide written consent. * Subject is at least 18 years of age at the time of consent. * Subject is geographically stable and willing and able to complete study procedures, including follow-up visits. * The subject's medical records must be accessible by the enrolling site over the…
CRT-D programmed for LBBAP (LV lead OFF)
CRT-D programmed for LOT-CRT (LBBAP + LV lead ON)
ICD programmed for LBBAP
CRT-D programmed for LOT-CRT (LBBAP + LV lead ON)
Arctuva estimate
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