PMID- 35189383
OWN - NLM
STAT- MEDLINE
DCOM- 20220707
LR  - 20240214
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Linking)
VI  - 19
IP  - 7
DP  - 2022 Jul
TI  - Leadless left ventricular endocardial pacing for cardiac resynchronization 
      therapy: A systematic review and meta-analysis.
PG  - 1176-1183
LID - S1547-5271(22)00199-0 [pii]
LID - 10.1016/j.hrthm.2022.02.018 [doi]
AB  - BACKGROUND: Leadless left ventricular (LV) endocardial pacing to achieve cardiac 
      resynchronization therapy (CRT) is a novel procedure for treatment of patients 
      with dyssynchronous heart failure. Current evidence is limited to observational 
      studies with small patient numbers. OBJECTIVE: The purpose of this systematic 
      review and meta-analysis was to assess the safety and efficacy of leadless LV 
      endocardial pacing. METHODS: A literature search was conducted through PubMed, 
      EMBASE, and Cochrane databases. Mean differences (MDs) in New York Heart 
      Association (NYHA) functional class and LV ejection fraction (LVEF) from baseline 
      to 6 months postprocedure were combined using a random effects model. 
      Heterogeneity was evaluated using the Cochrane Q test, I(2), meta-regression, and 
      sensitivity analysis. Funnel plots were constructed to detect publication bias. 
      RESULTS: Five studies with 181 patients were included in the final analysis. 
      Procedural success rate was 90.6%. Clinical response rate was 63%, with mean 
      improvement in NYHA functional class of 0.43 (MD -0.43; 95% confidence interval 
      [CI] -0.76 to -0.1; P = .01), with high heterogeneity (P <.001; I(2) = 81.1%). 
      There was a mean increase in LVEF of 6.3% (MD 6.3; 95% CI 4.35-8.19; P <.001, 
      with low heterogeneity (P = 0.84; I(2) <0.001%). The echocardiographic response 
      rate was 54%. Procedure-related complication and mortality rates were 23.8% and 
      2.8%, respectively. CONCLUSION: The efficacy of leadless LV endocardial pacing 
      for CRT supports its use as a second-line therapy in patients in whom standard 
      CRT is not possible or has been ineffective. Improvements in safety profile will 
      facilitate widespread uptake in the treatment of these patients.
CI  - Copyright (c) 2022 Heart Rhythm Society. Published by Elsevier Inc. All rights 
      reserved.
FAU - Wijesuriya, Nadeev
AU  - Wijesuriya N
AD  - School of Biomedical Engineering and Imaging Sciences, King's College London, 
      London, United Kingdom; Department of Cardiology, Guy's and St Thomas' NHS 
      Foundation Trust, London, United Kingdom. Electronic address: 
      nadeev.wijesuriya@kcl.ac.uk.
FAU - Elliott, Mark K
AU  - Elliott MK
AD  - School of Biomedical Engineering and Imaging Sciences, King's College London, 
      London, United Kingdom; Department of Cardiology, Guy's and St Thomas' NHS 
      Foundation Trust, London, United Kingdom.
FAU - Mehta, Vishal
AU  - Mehta V
AD  - School of Biomedical Engineering and Imaging Sciences, King's College London, 
      London, United Kingdom; Department of Cardiology, Guy's and St Thomas' NHS 
      Foundation Trust, London, United Kingdom.
FAU - Sidhu, Baldeep S
AU  - Sidhu BS
AD  - School of Biomedical Engineering and Imaging Sciences, King's College London, 
      London, United Kingdom; Department of Cardiology, Guy's and St Thomas' NHS 
      Foundation Trust, London, United Kingdom.
FAU - Behar, Jonathan M
AU  - Behar JM
AD  - School of Biomedical Engineering and Imaging Sciences, King's College London, 
      London, United Kingdom; Department of Cardiology, Guy's and St Thomas' NHS 
      Foundation Trust, London, United Kingdom.
FAU - Niederer, Steven
AU  - Niederer S
AD  - School of Biomedical Engineering and Imaging Sciences, King's College London, 
      London, United Kingdom.
FAU - Rinaldi, Christopher A
AU  - Rinaldi CA
AD  - School of Biomedical Engineering and Imaging Sciences, King's College London, 
      London, United Kingdom; Department of Cardiology, Guy's and St Thomas' NHS 
      Foundation Trust, London, United Kingdom.
LA  - eng
GR  - R01 HL152256/HL/NHLBI NIH HHS/United States
GR  - SP/18/6/33805/BHF_/British Heart Foundation/United Kingdom
GR  - PG/13/37/30280/BHF_/British Heart Foundation/United Kingdom
GR  - PG/15/91/31812/BHF_/British Heart Foundation/United Kingdom
GR  - WT203148/Z/16/Z/WT_/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20220218
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
MH  - *Cardiac Resynchronization Therapy/methods
MH  - Cardiac Resynchronization Therapy Devices
MH  - Endocardium
MH  - *Heart Failure/diagnosis/therapy
MH  - Heart Ventricles
MH  - Humans
MH  - Treatment Outcome
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Cardiac resynchronization therapy
OT  - Endocardial pacing
OT  - Heart failure
OT  - Leadless pacing
OT  - Meta-analysis
OT  - Systematic review
EDAT- 2022/02/22 06:00
MHDA- 2022/07/08 06:00
CRDT- 2022/02/21 20:11
PHST- 2022/01/13 00:00 [received]
PHST- 2022/02/01 00:00 [revised]
PHST- 2022/02/14 00:00 [accepted]
PHST- 2022/02/22 06:00 [pubmed]
PHST- 2022/07/08 06:00 [medline]
PHST- 2022/02/21 20:11 [entrez]
AID - S1547-5271(22)00199-0 [pii]
AID - 10.1016/j.hrthm.2022.02.018 [doi]
PST - ppublish
SO  - Heart Rhythm. 2022 Jul;19(7):1176-1183. doi: 10.1016/j.hrthm.2022.02.018. Epub 
      2022 Feb 18.