Heart failure & cardiomyopathiesMeta-analysis
Targeted left ventricular lead positioning to the site of latest activation in cardiac resynchronization therapy: a systematic review and meta-analysis
- Systematic review and meta-analysis of randomised trials
Authors' conclusion
In this study, a CRT implantation strategy that targets the latest LV activation did not improve survival or reduce heart failure hospitalizations.
Study context
- Population
- Cardiac resynchronization therapy (CRT) recipients
- Participants
- 1,323 recipients · 8 randomized controlled trials (RCTs)
- Comparison
- Guided vs Routine
- Guidedn = 638
- Routinen = 468reference
- Electrically-guidedn = 111
- Imaging-guidedn = 106
- Outcome
- Composite of:
- All-cause mortality
- HF hospitalization
- Follow-up
- 12-24 months
Pooled result
As reported in the abstract
Relative risk
0.83
95% CI 0.52–1.33
Guided vs Routine
RR 0.83 (95% CI 0.52–1.33)
Further pooled results
| Outcome | absolute difference (m) (95% CI) | |
|---|---|---|
| 6MWT distance · 6 months | 18 (6–30) | |
| −2002040Difference, m (linear scale) |
Quality of life, QRS duration, left ventricular (LV) end-systolic volume, LVEF
- No improvement with guided vs routine
Secondary endpoints, electrically- vs imaging-guided
- None of the secondary endpoints differed between the guided strategies
Original publication
Targeted left ventricular lead positioning to the site of latest activation in cardiac resynchronization therapy: a systematic review and meta-analysis. Europace. Published 11 September 2023. doi:10.1093/europace/euad267
Summarised from the published abstract; every number is checked against it