Heart failure & cardiomyopathies
Clinical Response to Resynchronization Therapy: Conduction System Pacing vs Biventricular Pacing: The CONSYST-CRT Trial
Primary result · All-cause mortality, cardiac transplant, heart failure hospitalization, or LVEF improvement <5 pointsResult — go to the resultMean difference −5.9 95% CI −21.1 to 9.2Authors' conclusion
CSP was noninferior to BiVP in achieving clinical and echocardiographic response, suggesting that CSP could be an alternative to BiVP. (Conduction System Pacing vs Biventricular Resynchronization Therapy in Systolic Dysfunction and Wide QRS [CONSYST-CRT]; NCT05187611).
Study context
- Population
- Patients with cardiac resynchronization therapy indicationrandomized, 67 per group
- Participants
- 134 patients
- Comparison
- Conduction system pacing (CSP) as compared with biventricular pacing (BiVP)
- CSPn = 67
- BiVPn = 67
- Primary endpoint
- All-cause mortality, cardiac transplant, heart failure hospitalization, or LVEF improvement <5 points
- Follow-up
- 12 months
Methodological detailscrossover allowed when the primary allocation procedure failed
- Crossover allowed when the primary allocation procedure failed
Primary result
As reported in the abstract
Mean difference
−5.9
95% CI −21.1 to 9.2
P = 0.02
By group
CSPvs BiVP
mean difference −5.9 (95% CI −21.1 to 9.2); P = 0.02
Secondary outcomes
Combined endpoint of all-cause mortality, cardiac transplantation, and heart failure hospitalization
Echocardiographic response (≥15% LVESV decrease)
| Outcome | CSP | BiVP |
|---|---|---|
| Crossover | crossed from CSP to BiVP 26.9% | crossed over from BiVP to CSP 7.5% |
| LVEF, LVESV and septal flash | ||
| LVEF | 14.1% ± 10% | 14.4% ± 10% |
| LVESV | −27.9% ± 27% | −27.9% ± 28% |
| Septal flash | −2.2 ± 2.7 mm | −2.7 ± 2.4 mm |
- Combined endpoint of all-cause mortality, cardiac transplantation, and heart failure hospitalization — Noninferiority
- P < 0.01 noninferiority (NI)
- Echocardiographic response (≥15% LV end-systolic volume (LVESV) decrease) — Noninferiority
- P = 0.03 NI
NYHA functional class
- Noninferiority
- P < 0.001 NI
QRS shortening
- Noninferiority
- P < 0.01
Left ventricular ejection fraction (LVEF), LVESV and septal flash
- Values similar, but noninferiority was not met
Original publication
Clinical Response to Resynchronization Therapy: Conduction System Pacing vs Biventricular Pacing: The CONSYST-CRT Trial. JACC Clin Electrophysiol. Published 14 May 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →