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Among patients given cardiac resynchronization therapy (CRT), approximately 30% fail to respond, and efforts to reduce this rate are ongoing. In the current global, prospective, manufacturer-sponsored trial, researchers tested a novel algorithm of adaptive timing of left ventricular pacing relative to the right bundle native conduction. Theoretically, this adaptive pacing could more accurately replicate physiologic conduction compared with conventional CRT.
Some 3800 patients who had heart failure with intact atrioventricular conduction and left bundle branch block were randomly assigned to adaptive CRT or conventional CRT. Participants' mean age was 65 years, and 43% were women. The primary endpoint was a composite of all-cause death or int…