# Evaluation of Left Bundle Branch Area Pacing As A Rescue Strategy for Cardiac Resynchronization Therapy Non-response in Patients With Heart Failure: A Randomized Controlled Trial

> **NIH VA IK2** · MINNEAPOLIS VA  MEDICAL CENTER · 2024 · —

## Abstract

Overview: I am reapplying for a 5-year Career Development Award (CDA) to support my overarching goal of
studying how imaging tools can improving care of heart failure (HF) patients who require device therapy. This
will be accomplished through the completion of mentored research activities and formal training designed to
provide the skills necessary to become an independent investigator. During the course of my award, I will study
an innovative method of cardiac resynchronization therapy (CRT) in patients with HF who have not had an
improvement in cardiac function with the standard treatment of care. I also plan to establish the feasibility of
cardiac MRI to assess cardiac function over time in patients with heart failure treated with device therapy.
Significance: HF is one of the most common conditions cared for by the Veterans Health Administration and
has a 15% annual mortality rate in VA patients. Approximately 50% of the hospitalizations for HF occur in
patients with reduced ejection fraction (HFrEF). In these patients, a primary treatment goal includes strategies
to increase the cardiac fraction, which has been shown to improve symptoms and decrease the risk of sudden
cardiac death. In patients who also have a left bundle branch block, the main therapy has involved placing
cardiac pacing leads in the right ventricle and in a cardiac vein overlying the left ventricle, referred to as CRT.
However, up to 40% patients who undergo CRT fail to experience the expected improvement in cardiac
function and symptoms after 6 months and are referred to as “non-responders.” This study aims to improve
cardiac function in “non-responders” by pacing the heart from the left bundle branch area, thereby utilizing the
heart’s intrinsic electrical system to promote coordinated ventricular contractions. The intervention developed
in this CDA proposal has the potential for wide-reaching impact as it could significantly decrease the morbidity
and mortality of HFrEF patients and reduce costs and burdens placed on the VA health care system.
Career Plan: My primary area of research has focused on improving outcomes for patients with heart failure.
To successfully achieve my goals of improving care for heart failure patients that require device therapy, I need
further mentored training in implementation science including: quantitative and mixed methods training,
expertise in diagnostic imaging training and research (particularly cardiac MRI), further biostatistics training,
and cultivating multidisciplinary collaboration and networking skills. I will achieve these objectives through
formal coursework, seminars, and mentored research activities under the guidance of primary mentors Selçuk
Adabag, MD, MS (MVAHCS) and Chetan Shenoy, MBBS, MS (University of Minnesota Department of
Cardiology), and secondary mentors Bradley Bart, MD (MVAHCS) and Sue Duval (University of Minnesota
Department of Cardiology). The mentored research training through this grant will lay the ground...

## Key facts

- **NIH application ID:** 10862628
- **Project number:** 5IK2CX002525-02
- **Recipient organization:** MINNEAPOLIS VA  MEDICAL CENTER
- **Principal Investigator:** Selma D Carlson
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10862628

## Citation

> US National Institutes of Health, RePORTER application 10862628, Evaluation of Left Bundle Branch Area Pacing As A Rescue Strategy for Cardiac Resynchronization Therapy Non-response in Patients With Heart Failure: A Randomized Controlled Trial (5IK2CX002525-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10862628. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*