ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1551551
This article is part of the Research TopicA Patient-Centered Approach to the Management of Heart Failure and ComorbiditiesView all 9 articles
Changes in oxygen uptake in patients with non-ischemic dilated cardiomyopathy and left bundle branch block following left bundle branch area pacing
Provisionally accepted
Guillermo Gutierrez Ballesteros*
Francisco Mazuelos BellidoJose López AguileraManuel Crespín CrespínRafael González ManzanaresAsunción García MerinoDolores Mesa RubioMiguel Romero MorenoManuel Pan Álvarez-OsorioJosé María Segura Saint-Gerons- Reina Sofia University Hospital, Cordoba, Spain
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Left bundle branch area pacing (LBBAP) has good clinical and echocardiographic outcomes and seems to be an alternative to conventional resynchronization therapy. However, data regarding functional outcomes are scarce. Our objective was to evaluate, using cardiopulmonary exercise testing (CET), changes in the functional capacity of patients with indication for cardiac resynchronization therapy after LBBAP.Prospective analysis of a cohort of patients with non-ischaemic dilated cardiomyopathy, left bundle branch block, QRS > 130 ms, functional class II-IV and left ventricular ejection fraction (LVEF) < 40% who underwent LBBAP. CET was performed before the procedure and after 6 months of follow-up. The primary endpoint was the change in peak oxygen uptake(VO2).Secondary endpoints included evaluation of clinical, echocardiographic, analytical and other CET parameters.A total of 50 patients were included (44% female, 64 ± 11 years, LVEF 28 ± 7%). At baseline, peak VO2 was 15.4 ± 4.9 mL/kg/min and VO2 at the first ventilatory threshold 10.5 ± 2.9 mL/kg/min. At follow-up, we observed an increase of 3 mL/kg/min (95% CI 1.7-4.4; p < 0.01) and 2.6 mL/kg/min (95% CI 1.6-3.5; p < 0.01), respectively. Independent predictors of peak VO2 at follow-up were baseline peak VO2 and baseline QRS duration.Improvement was observed in the remaining CET, echocardiography and clinical parameters.In symptomatic patients with non-ischaemic dilated cardiomyopathy, LVEF < 40% and left bundle branch block, LBBAP is associated with an improvement in peak VO2. Baseline QRS duration and baseline peak VO2 were independent predictors of this parameter at follow-up.
Keywords: Cardiopulmonary exercise test, dilated cardiomyopathy, Left bundle branch block, left bundle branch area pacing, Oxygen Uptake
Received: 25 Dec 2024; Accepted: 12 Aug 2025.
Copyright: © 2025 Gutierrez Ballesteros, Mazuelos Bellido, López Aguilera, Crespín Crespín, González Manzanares, García Merino, Mesa Rubio, Romero Moreno, Pan Álvarez-Osorio and Segura Saint-Gerons. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Guillermo Gutierrez Ballesteros, Reina Sofia University Hospital, Cordoba, Spain
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