Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies
Background: The effects of conduction system pacing (CSP) compared with conventional biventricular pacing (BVP) on heart function in patients with heart failure remain elusive.Methods: PubMed, Embase, Cochrane’s Library and Web of science databases were searched up to 1 October 2022 for pertinent co...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-05-01
|
| Series: | Frontiers in Physiology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2023.1125340/full |
| _version_ | 1797833079229775872 |
|---|---|
| author | Jie Zhang Feng Li Zhi-Yuan Zhang Fan Yang Qi Kong Jia-Yi Chen Lei Zhang Huan-Huan Liu Xu-Fei Chen Yu-Heng Ye Ru-Xing Wang |
| author_facet | Jie Zhang Feng Li Zhi-Yuan Zhang Fan Yang Qi Kong Jia-Yi Chen Lei Zhang Huan-Huan Liu Xu-Fei Chen Yu-Heng Ye Ru-Xing Wang |
| author_sort | Jie Zhang |
| collection | DOAJ |
| description | Background: The effects of conduction system pacing (CSP) compared with conventional biventricular pacing (BVP) on heart function in patients with heart failure remain elusive.Methods: PubMed, Embase, Cochrane’s Library and Web of science databases were searched up to 1 October 2022 for pertinent controlled studies. Random or fixed-effect model were used to synthesize the clinical outcomes. Subgroup analysis was performed to screen the potential confounding factors.Results: Fifteen studies including 1,347 patients were enrolled. Compared with BVP, CSP was significantly associated with shortened QRS duration [WMD -22.51 ms; p = 0.000], improved left ventricular ejection fraction [WMD 5.53%; p = 0.000], improved NYHA grade [WMD -0.42; p = 0.000], higher response rate and lower heart failure rehospitalization rate. CSP resulted in better clinical outcomes in higher male proportion group than lower one compared with BVP. No significant differences of clinical outcomes were observed between left bundle branch area pacing (LBBaP) and his bundle pacing (HBP) except the pacing threshold. The pacing threshold of LBBaP was significantly lower than those in BVP and HBP.Conclusion: This study suggests that CSP might be superior to conventional BVP for HF patients. In a higher male proportion group, CSP may be associated with more benefits than BVP.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022355991; Identifier: CRD42022355991. |
| first_indexed | 2024-04-09T14:19:04Z |
| format | Article |
| id | doaj.art-ed6e4f98471046218b3fcc2067bbb55e |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-09T14:19:04Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-ed6e4f98471046218b3fcc2067bbb55e2023-05-05T05:43:19ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2023-05-011410.3389/fphys.2023.11253401125340Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studiesJie ZhangFeng LiZhi-Yuan ZhangFan YangQi KongJia-Yi ChenLei ZhangHuan-Huan LiuXu-Fei ChenYu-Heng YeRu-Xing WangBackground: The effects of conduction system pacing (CSP) compared with conventional biventricular pacing (BVP) on heart function in patients with heart failure remain elusive.Methods: PubMed, Embase, Cochrane’s Library and Web of science databases were searched up to 1 October 2022 for pertinent controlled studies. Random or fixed-effect model were used to synthesize the clinical outcomes. Subgroup analysis was performed to screen the potential confounding factors.Results: Fifteen studies including 1,347 patients were enrolled. Compared with BVP, CSP was significantly associated with shortened QRS duration [WMD -22.51 ms; p = 0.000], improved left ventricular ejection fraction [WMD 5.53%; p = 0.000], improved NYHA grade [WMD -0.42; p = 0.000], higher response rate and lower heart failure rehospitalization rate. CSP resulted in better clinical outcomes in higher male proportion group than lower one compared with BVP. No significant differences of clinical outcomes were observed between left bundle branch area pacing (LBBaP) and his bundle pacing (HBP) except the pacing threshold. The pacing threshold of LBBaP was significantly lower than those in BVP and HBP.Conclusion: This study suggests that CSP might be superior to conventional BVP for HF patients. In a higher male proportion group, CSP may be associated with more benefits than BVP.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022355991; Identifier: CRD42022355991.https://www.frontiersin.org/articles/10.3389/fphys.2023.1125340/fullleft bundle branch area pacingcardiac resynchronization therapybiventricular pacingheart failurehis bundle pacing (HBP) |
| spellingShingle | Jie Zhang Feng Li Zhi-Yuan Zhang Fan Yang Qi Kong Jia-Yi Chen Lei Zhang Huan-Huan Liu Xu-Fei Chen Yu-Heng Ye Ru-Xing Wang Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies Frontiers in Physiology left bundle branch area pacing cardiac resynchronization therapy biventricular pacing heart failure his bundle pacing (HBP) |
| title | Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies |
| title_full | Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies |
| title_fullStr | Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies |
| title_full_unstemmed | Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies |
| title_short | Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies |
| title_sort | conduction system pacing is superior to biventricular pacing in patients with heart failure insights from the pooled clinical studies |
| topic | left bundle branch area pacing cardiac resynchronization therapy biventricular pacing heart failure his bundle pacing (HBP) |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2023.1125340/full |
| work_keys_str_mv | AT jiezhang conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies AT fengli conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies AT zhiyuanzhang conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies AT fanyang conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies AT qikong conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies AT jiayichen conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies AT leizhang conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies AT huanhuanliu conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies AT xufeichen conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies AT yuhengye conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies AT ruxingwang conductionsystempacingissuperiortobiventricularpacinginpatientswithheartfailureinsightsfromthepooledclinicalstudies |