Using ultra‑high‑frequency ECG to distinguish true LBBB and guide whether left bundle branch or biventricular pacing is best

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This interventional project uses ultra‑high‑frequency ECG (UHF‑ECG) to map ventricular activation patterns and distinguish proximal ('true') LBBB from more distal intraventricular conduction delay (IVCD). Patients with heart failure, LVEF ≤40%, NYHA II–IV and non‑RBBB QRS ≥130 ms will undergo UHF‑ECG and either invasive EP confirmation or validated non‑invasive dyssynchrony assessment, then receive CRT by left bundle branch area pacing (LBBAP) or biventricular pacing (BVP). The study compares electrical dyssynchrony changes, echocardiographic remodeling, and clinical response between groups to see which pacing approach gives greater improvement in patients identified as true LBBB. Pilot data guiding the protocol suggest distinct activation patterns on UHF‑ECG and larger dyssynchrony in true LBBB patients.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* HF due to ischemic or non-ischemic cardiomyopathy
* known coronary angiography
* NYHA II-IV
* LVEF ≤40%
* non-RBBB QRSd lasting \>130 ms (by automated measurement)
* proximal LBBB proved by an invasive EP study or non-invasive dyssynchrony assessment in case such a method is confirmed to be non-inferior to an invasive EP study during the project

Exclusion Criteria:

* Age ˂18 years
* heart failure from reversible causes
* Moderate to severe aortic stenosis
* pregnancy
* active myocarditis
* hypertrophic cardiomyopathy
* cardiac valve surgery in the last three months
* myocardial infarction, PCI, or CABG in the last three months
* severe valvular disease requiring intervention
* severe atherosclerotic disease of the aorta and/or femoral arteries
* life expectancy ˂1 year
* known medical condition or contraindication causing potential complications for EP study

Where it's running

• Faculty Hospital Kralovske Vinohrady
  Prague, Česká Republika, Czechia Recruiting

Study contacts

• Study coordinator: Karol Curila, MD
• Email: karol.curila@fnkv.cz
• Phone: +420777869171

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.