Heart failure & cardiomyopathies
Conduction system pacing versus biventricular pacing in heart failure with reduced ejection fraction: A systematic review and meta-analysis of randomized controlled trials
Authors' conclusion
These findings suggest that CSP may have electrocardiographic, echocardiographic, and symptomatic benefits over BVP for patients with HFrEF requiring cardiac resynchronization.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) and ventricular dyssynchrony requiring cardiac resynchronization
- Participants
- 408 patients7 RCTs
- Comparison
- Conduction system pacing vs biventricular pacing
- Conduction system pacing (CSP)n = 200
- Outcome
- Clinical outcomes of CSP vs biventricular pacing (BVP) for cardiac resynchronization
Methodological detailsrandom-effects model
- Random-effects model
Pooled result
As reported in the abstract
CSP vs BVPMD, ms (95% CI)P value
QRS duration; I2 = 91%
−13.34(−24.32 to −2.36)
P = 0.02CSP vs BVPSMD (95% CI)P value
NYHA functional class; I2 = 41%
−0.37(−0.69 to −0.05)
P = 0.02CSP vs BVPMD, % (95% CI)P value
LVEF; I2 = 0%
2.06(0.16–3.97)
P = 0.03- No statistical difference in LV end-systolic volume
- SMD −0.51 mL; 95% CI −1.26 to 0.24; P = .18; I2 = 83%
- No statistical difference in lead capture threshold
- MD −0.08 V; 95% CI −0.42 to 0.27; P = .66; I2 = 66%
- No statistical difference in procedure time
- MD 5.99 minutes; 95% CI −15.91 to 27.89; P = .59; I2 = 79%
Original publication
Conduction system pacing versus biventricular pacing in heart failure with reduced ejection fraction: A systematic review and meta-analysis of randomized controlled trials. Heart Rhythm. Published 19 February 2024. doi:10.
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