PMID- 37842060
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231026
IS  - 2167-8359 (Electronic)
IS  - 2167-8359 (Linking)
VI  - 11
DP  - 2023
TI  - Beneficial effects of upgrading to His-Purkinje system pacing in patients with 
      pacing-induced cardiomyopathy: a systematic review and meta-analysis.
PG  - e16268
LID - 10.7717/peerj.16268 [doi]
LID - e16268
AB  - BACKGROUND: The purpose of this study was to evaluate the effectiveness of 
      His-Purkinje system pacing (HPSP) in the management of patients with pace-induced 
      cardiomyopathy (PICM). METHODS: PubMed, Embase, Web of Science, and the Cochrane 
      Library were searched comprehensively to collect related studies published from 
      the inception of databases to June 1, 2022. R 4.04 software, including the 
      Metafor package, matrix package, and the Meta package, was utilized to conduct 
      the singe-arm meta-analysis. The methodology index for non-randomized studies 
      (MINORS) was used to assess the methodological quality of the included studies. 
      RESULTS: A total of seven studies were included, involving 164 PICM patients. The 
      meta-analysis showed that HPSP ameliorated the left ventricular ejection fraction 
      (LVEF) by 13.41% (95% CI [11.21-15.61]), improved the New York Heart Association 
      (NYHA) classification by 1.02 (95% CI [-1.41 to -0.63]), and shortened the QRS 
      duration (QRSd) by 60.85 ms (95% CI [-63.94 to -57.75]), resulting in improved 
      cardiac functions in PICM patients. Besides, HPSP reversed the ventricular 
      remodeling, with a 32.46 ml (95% CI [-53.18 to -11.75]) decrease in left 
      ventricular end systolic volume (LVESV) and a 5.93 mm (95% CI [-7.68 to -4.19]) 
      decrease in left ventricular end-diastolic dimension (LVEDD). HPSP also showed 
      stable electrical parameters of pacemakers, with a 0.07 V (95% CI [0.01-0.13]) 
      increase in pacing threshold, a 0.02 mV (95% CI [-0.85 to 0.90]) increase in 
      sensed R-wave amplitude, and a 31.12 Omega reduction in impedance (95% CI [-69.62 to 
      7.39]). Compared with LBBP, HBP improved LVEF by 13.28% (95% CI [-11.64 to 
      14.92]) vs 14.43% (95% CI [-13.01 to 15.85]), ameliorated NHYA classification by 
      1.18 (95% CI [-1.97 to -0.39]) vs 0.95 (95% CI [-1.33 to -0.58]), shortened QRSd 
      by 63.16 ms (95% CI [-67.00 to -59.32]) vs 57.98 ms (95% CI [-62.52 to -53.25]), 
      and decreased LVEDD by 4.12 mm (95% CI [-5.79 to -2.45]) vs 6.26 mm (95% CI 
      [-62.52 to -53.25]). The electrical parameters of the pacemaker were stable in 
      both groups. CONCLUSIONS: This meta-analysis showed that HPSP could significantly 
      improve cardiac function, promote reverse remodeling, and provide stable 
      electrical parameters of pacemakers for PICM patients.
CI  - (c) 2023 Tang et al.
FAU - Tang, Nian
AU  - Tang N
AD  - Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute 
      of Chengdu, Department of Cardiology, Chengdu Fifth People's Hospital (The Second 
      Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu 
      University of Traditional Chinese Medicine), Chengdu, China.
FAU - Chen, Xiaoxiao
AU  - Chen X
AD  - Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute 
      of Chengdu, Department of Cardiology, Chengdu Fifth People's Hospital (The Second 
      Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu 
      University of Traditional Chinese Medicine), Chengdu, China.
FAU - Li, Hongfei
AU  - Li H
AD  - Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute 
      of Chengdu, Department of Cardiology, Chengdu Fifth People's Hospital (The Second 
      Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu 
      University of Traditional Chinese Medicine), Chengdu, China.
FAU - Zhang, Denghong
AU  - Zhang D
AD  - Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute 
      of Chengdu, Department of Cardiology, Chengdu Fifth People's Hospital (The Second 
      Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu 
      University of Traditional Chinese Medicine), Chengdu, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20231011
PL  - United States
TA  - PeerJ
JT  - PeerJ
JID - 101603425
SB  - IM
MH  - Humans
MH  - Stroke Volume
MH  - Ventricular Function, Left
MH  - Cardiac Pacing, Artificial/adverse effects
MH  - *Cardiomyopathies/etiology
MH  - *Pacemaker, Artificial
PMC - PMC10576494
OTO - NOTNLM
OT  - His-purkinje system packing
OT  - Left bundle branch pacing
OT  - Meta-analysis
OT  - Pacing-induced cardiomyopathy
OT  - Systematic review
COIS- The authors declare that they have no competing interests.
EDAT- 2023/10/16 06:48
MHDA- 2023/10/23 01:18
PMCR- 2023/10/11
CRDT- 2023/10/16 04:47
PHST- 2023/06/28 00:00 [received]
PHST- 2023/09/19 00:00 [accepted]
PHST- 2023/10/23 01:18 [medline]
PHST- 2023/10/16 06:48 [pubmed]
PHST- 2023/10/16 04:47 [entrez]
PHST- 2023/10/11 00:00 [pmc-release]
AID - 16268 [pii]
AID - 10.7717/peerj.16268 [doi]
PST - epublish
SO  - PeerJ. 2023 Oct 11;11:e16268. doi: 10.7717/peerj.16268. eCollection 2023.