PMID- 37767743
OWN - NLM
STAT- MEDLINE
DCOM- 20231120
LR  - 20231120
IS  - 1540-8167 (Electronic)
IS  - 1045-3873 (Linking)
VI  - 34
IP  - 11
DP  - 2023 Nov
TI  - Effectiveness of conduction system pacing for cardiac resynchronization therapy: 
      A systematic review and network meta-analysis.
PG  - 2342-2359
LID - 10.1111/jce.16086 [doi]
AB  - INTRODUCTION: Cardiac resynchronization therapy (CRT) with biventricular pacing 
      (BiV-CRT) is ineffective in approximately one-third of patients. CRT with 
      Conduction system pacing (CSP-CRT) may achieve greater synchronization. We aimed 
      to assess the effectiveness of CRT with His pacing (His-CRT) or left bundle 
      branch pacing (LBB-CRT) in lieu of biventricular CRT. METHODS AND RESULTS: The 
      PubMed, Embase, Web of Science, Scopus, and the Cochrane Library were 
      systematically searched until August 19, 2023, for original studies including 
      patients with reduced left ventricular ejection fraction (LVEF) who received His- 
      or LBB-CRT, that reported either CSP-CRT success, LVEF, QRS duration (QRSd), or 
      New York Heart Association (NYHA) classification. Effect measures were compared 
      with frequentist network meta-analysis. Thirty-seven publications, including 20 
      comparative studies, were included. Success rates were 73.5% (95% CI: 61.2-83.0) 
      for His-CRT and 91.5% (95% CI: 88.0-94.1) for LBB-CRT. Compared to BiV-CRT, 
      greater improvements were observed for LVEF (mean difference [MD] for His-CRT 
      +3.4%; 95% CI [1.0; 5.7], and LBB-CRT: +4.4%; [2.5; 6.2]), LV end-systolic volume 
      (His-CRT:17.2mL [29.7; 4.8]; LBB-CRT:15.3mL [28.3; 2.2]), QRSd (His-CRT: -17.1ms 
      [-25.0; -9.2]; LBB-CRT: -17.4ms [-23.2; -11.6]), and NYHA (Standardized MD [SMD]: 
      His-CRT:0.4 [0.8; 0.1]; LBB-CRT:0.4 [-0.7; -0.2]). Pacing thresholds at baseline 
      and follow-up were significantly lower with LBB-CRT versus both His-CRT and 
      BiV-CRT. CSP-CRT was associated with reduced mortality (R = 0.75 [0.61-0.91]) and 
      hospitalizations risk (RR = 0.63 [0.42-0.96]). CONCLUSION: This study found that 
      CSP-CRT is associated with greater improvements in QRSd, echocardiographic, and 
      clinical response. LBB-CRT was associated with lower pacing thresholds. Future 
      randomized trials are needed to determine CSP-CRT efficacy.
CI  - (c) 2023 The Authors. Journal of Cardiovascular Electrophysiology published by 
      Wiley Periodicals LLC.
FAU - Tavolinejad, Hamed
AU  - Tavolinejad H
AUID- ORCID: 0000-0002-0244-5914
AD  - Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular 
      Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
FAU - Kazemian, Sina
AU  - Kazemian S
AUID- ORCID: 0000-0002-2559-0858
AD  - Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular 
      Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
FAU - Bozorgi, Ali
AU  - Bozorgi A
AD  - Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular 
      Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
FAU - Michalski, Roman
AU  - Michalski R
AD  - Clinic and Polyclinic for Cardiology, Angiology and Intensive Care, University 
      Hospital Halle, Martin-Luther University, Halle (Saale), Germany.
FAU - Hoyer, Daniel
AU  - Hoyer D
AD  - Clinic and Polyclinic for Cardiology, Angiology and Intensive Care, University 
      Hospital Halle, Martin-Luther University, Halle (Saale), Germany.
FAU - Sedding, Daniel
AU  - Sedding D
AD  - Clinic and Polyclinic for Cardiology, Angiology and Intensive Care, University 
      Hospital Halle, Martin-Luther University, Halle (Saale), Germany.
FAU - Arya, Arash
AU  - Arya A
AD  - Clinic and Polyclinic for Cardiology, Angiology and Intensive Care, University 
      Hospital Halle, Martin-Luther University, Halle (Saale), Germany.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230928
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
SB  - IM
MH  - Humans
MH  - *Cardiac Resynchronization Therapy/adverse effects/methods
MH  - Stroke Volume/physiology
MH  - Ventricular Function, Left/physiology
MH  - Network Meta-Analysis
MH  - Treatment Outcome
MH  - Cardiac Conduction System Disease
MH  - *Heart Failure/diagnosis/therapy
MH  - Bundle of His
MH  - Electrocardiography/methods
OTO - NOTNLM
OT  - His pacing
OT  - biventricular pacing
OT  - cardiac resynchronization therapy
OT  - conduction system pacing
OT  - left bundle branch pacing
OT  - network meta-analysis
EDAT- 2023/09/28 06:43
MHDA- 2023/11/20 06:54
CRDT- 2023/09/28 05:34
PHST- 2023/08/31 00:00 [revised]
PHST- 2023/05/22 00:00 [received]
PHST- 2023/09/17 00:00 [accepted]
PHST- 2023/11/20 06:54 [medline]
PHST- 2023/09/28 06:43 [pubmed]
PHST- 2023/09/28 05:34 [entrez]
AID - 10.1111/jce.16086 [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2023 Nov;34(11):2342-2359. doi: 10.1111/jce.16086. 
      Epub 2023 Sep 28.