ID: 4349863 DIRECT-FROM-ECG DYNAMIC VENTRICULAR DYSSYCHRONY-GUIDED BIV PACING AND ADAPTIVE CRT OPTIMIZATION TO IMPROVE OUTCOMES IN HEART FAILURE PATIENTS

Despite advances in biventricular (BiV) and adaptive pacemakers, ventricular dyssynchrony remains a major driver of heart failure progression, adverse conduction remodeling and hospitalization in HFrEF patients. Subclinical desynchronization persists in high proportion of CRT recipients—even with BiV pacing ≥95%—and is associated with worsened outcomes, including a 2.9-fold increase in heart failure admissions and mortality. Chronic RV pacing ≥20% further elevates the risk of pacing-induced cardiomyopathy (PiCM).