Arrhythmias & electrophysiologyMeta-analysis
A comparative analysis of conduction system pacing and biventricular pacing in patients undergoing atrioventricular node ablation: a systematic review and meta-analysis
- Systematic review and meta-analysis
- random effects meta-analysis
- PRISMA
Authors' conclusion
Conduction system pacing with AVNA is a safe and feasible treatment option for symptomatic (AF) patients undergoing a pace and ablate strategy, offering an alternative to BVP. Overall, CSP results in a narrower QRS duration while providing comparable clinical and echocardiographic outcomes.
Study context
- Population
- Patients with AF with uncontrolled ventricular rates undergoing atrioventricular node ablation (AVNA) with pacemaker implantation25 studies
- Participants
- 1,652 vs 369
- Comparison
- Conduction system pacing (CSP) vs biventricular pacing (BVP) with AVNA
- CSPn = 1,652
- BVPn = 369reference
Pooled result
QRS duration (QRSd)
Change
−35.8 ms
95% CI −61.8 to −9.72
P < 0.05
CSP vs BVP
change −35.8 ms (95% CI −61.8 to −9.72); P < 0.05
As reported in the abstract
Further pooled results
Procedural and fluoroscopy times
- No significant differences, CSP vs BVP
Safety
| Outcome | Log odds ratio (95% CI) | P value |
|---|---|---|
| Acute threshold elevation (HBP vs BVP) · I2 = 0.00 | −0.69 (−2.05-0.66) | P = 0.32 |
Periprocedural complications
- Comparable, CSP vs BVP
Original publication
A comparative analysis of conduction system pacing and biventricular pacing in patients undergoing atrioventricular node ablation: a systematic review and meta-analysis. Europace. Published 11 July 2025. doi:10.1093/europace/euaf106
Summarised from the published abstract; every number is checked against it