PMID- 29344950
OWN - NLM
STAT- MEDLINE
DCOM- 20190227
LR  - 20220409
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 41
IP  - 4
DP  - 2018 Apr
TI  - Systematic review and meta-analysis of left ventricular endocardial pacing in 
      advanced heart failure: Clinically efficacious but at what cost?
PG  - 353-361
LID - 10.1111/pace.13275 [doi]
AB  - INTRODUCTION: Cardiac resynchronization using a left ventricular (LV) epicardial 
      lead placed in the coronary sinus is now routinely used in the management of 
      heart failure patients. LV endocardial pacing is an alternative when this is not 
      feasible, with outcomes data sparse. OBJECTIVE: To review the available evidence 
      on the efficacy and safety of endocardial LV pacing via meta-analysis. METHODS: 
      EMBASE, MEDLINE, and COCHRANE databases with the search term "endocardial 
      biventricular pacing" or "endocardial cardiac resynchronization" or "left 
      ventricular endocardial" or "endocardial left ventricular." Comparisons of 
      pre-and post-QRS width, LV ejection fraction (LVEF), and New York Heart 
      Association (NYHA) functional classification was performed, and mean differences 
      (and respective 95% confidence interval [CI]) applied as a measurement of 
      treatment effect. RESULTS: Fifteen studies, including 362 patients, were 
      selected. During a mean follow-up of 40 +/- 24.5 months, death occurred in 72 
      patients (11 per 100 patient-years). Significant improvements in LVEF (mean 
      difference 7.9%, 95% CI 5-10%, P < 0.0001; I(2)  = 73%), QRS width (mean 
      difference: -41% 95% -75 to -7%; P < 0.0001; I(2)  = 94%), and NYHA class (mean 
      difference: -1.06, 95% CI -1.2 to -0.9, P < 0.0001; I(2)  = 60%), (all 
      P < 0.0001) occurred. Stroke rate was 3.3-4.2 per 100 patient-years, which is 
      higher than equivalent heart failure trial populations and recent meta-analysis 
      that included small case series. CONCLUSION: LV endocardial lead implantation is 
      a potentially efficacious alternative to CS lead placement, but preliminary data 
      suggest a potentially higher risk of stroke during follow-up when compared to the 
      expected incidence of stroke in similar cohorts of patients.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Graham, Adam J
AU  - Graham AJ
AUID- ORCID: 0000-0002-2392-034X
AD  - Clinical Research Fellow, Barts Heart Centre, West Smithfield, London, EC1A 7BE, 
      UK.
FAU - Providenica, Rui
AU  - Providenica R
AD  - Clinical Research Fellow, Barts Heart Centre, West Smithfield, London, EC1A 7BE, 
      UK.
FAU - Honarbakhsh, Shohreh
AU  - Honarbakhsh S
AD  - Clinical Research Fellow, Barts Heart Centre, West Smithfield, London, EC1A 7BE, 
      UK.
FAU - Srinivasan, Neil
AU  - Srinivasan N
AD  - Clinical Research Fellow, Barts Heart Centre, West Smithfield, London, EC1A 7BE, 
      UK.
FAU - Sawhney, Vinit
AU  - Sawhney V
AD  - Clinical Research Fellow, Barts Heart Centre, West Smithfield, London, EC1A 7BE, 
      UK.
FAU - Hunter, Ross
AU  - Hunter R
AD  - Consultant Electrophysiologist and Clinical lecturer, Barts Heart Centre, West 
      Smithfield, London, EC1A 7BE, UK.
FAU - Lambiase, Pier
AU  - Lambiase P
AD  - Consultant Electrophysiologist and Clinical lecturer, Barts Heart Centre, West 
      Smithfield, London, EC1A 7BE, UK.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20180312
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Cardiac Pacing, Artificial/*methods
MH  - Cardiac Resynchronization Therapy/methods
MH  - Endocardium/*physiopathology
MH  - Heart Failure/*physiopathology/*prevention & control
MH  - Humans
OTO - NOTNLM
OT  - LV Lead
OT  - endocardial
OT  - resynchronization
OT  - stroke
EDAT- 2018/01/19 06:00
MHDA- 2019/02/28 06:00
CRDT- 2018/01/19 06:00
PHST- 2017/08/22 00:00 [received]
PHST- 2017/12/04 00:00 [revised]
PHST- 2017/12/22 00:00 [accepted]
PHST- 2018/01/19 06:00 [pubmed]
PHST- 2019/02/28 06:00 [medline]
PHST- 2018/01/19 06:00 [entrez]
AID - 10.1111/pace.13275 [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2018 Apr;41(4):353-361. doi: 10.1111/pace.13275. Epub 
      2018 Mar 12.