Heart failure & cardiomyopathies
Effectiveness and safety of upgrading to conduction system pacing compared with biventricular pacing in patients with pacing-induced cardiomyopathy: Results of a propensity score–matched analysis from a multicenter registry
Authors' conclusion
In patients with PICM, upgrading to CSP could reduce the risk of all-cause death or heart failure hospitalization, as well as the incidence of procedure-related complications, compared with BVP.
Study context
- Population
- Patients with pacing-induced cardiomyopathy undergoing upgrade (54.1% NYHA class >II; mean LVEF 33.2% ± 8.4%)
- Participants
- 183 patients57 matched pairs
- Exposure
- Upgrade to conduction system pacing (CSP) vs biventricular pacing (BVP)
- CSPn = 69
- BVPn = 114reference
- Outcome
- Composite of:
- All-cause death
- HF hospitalization
- Follow-up
- Median 22.8 months
Methodological detailsmulticenter, propensity-score matched, observational
- Multicenter
- Propensity-score matched
- Observational
Main finding
As reported in the abstract
P = 0.010
Observational data: associations, not effects.
Secondary outcomes
| Outcome | CSP | BVP | P value |
|---|---|---|---|
| Change in LVEF · 12 months | +15.3 (SD 7.3) % | +11.1 (SD 13.5) % | P = 0.039 |
| Change in NYHA class · 12 months | −1.3 (SD 0.7) | −0.8 (SD 0.8) | P < 0.001 |
Safety
Procedure-related complications
P = 0.047
Original publication
Effectiveness and safety of upgrading to conduction system pacing compared with biventricular pacing in patients with pacing-induced cardiomyopathy: Results of a propensity score–matched analysis from a multicenter registry. Heart Rhythm. Published 5 December 2025. doi:10.
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