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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 c...

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Autores principales: Zhang, Jie, Li, Feng, Zhang, Zhi-Yuan, Yang, Fan, Kong, Qi, Chen, Jia-Yi, Zhang, Lei, Liu, Huan-Huan, Chen, Xu-Fei, Ye, Yu-Heng, Wang, Ru-Xing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196184/
https://www.ncbi.nlm.nih.gov/pubmed/37215180
http://dx.doi.org/10.3389/fphys.2023.1125340
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author Zhang, Jie
Li, Feng
Zhang, Zhi-Yuan
Yang, Fan
Kong, Qi
Chen, Jia-Yi
Zhang, Lei
Liu, Huan-Huan
Chen, Xu-Fei
Ye, Yu-Heng
Wang, Ru-Xing
author_facet Zhang, Jie
Li, Feng
Zhang, Zhi-Yuan
Yang, Fan
Kong, Qi
Chen, Jia-Yi
Zhang, Lei
Liu, Huan-Huan
Chen, Xu-Fei
Ye, Yu-Heng
Wang, Ru-Xing
author_sort Zhang, Jie
collection PubMed
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.
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spelling pubmed-101961842023-05-20 Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies Zhang, Jie Li, Feng Zhang, Zhi-Yuan Yang, Fan Kong, Qi Chen, Jia-Yi Zhang, Lei Liu, Huan-Huan Chen, Xu-Fei Ye, Yu-Heng Wang, Ru-Xing Front Physiol Physiology 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. Frontiers Media S.A. 2023-05-05 /pmc/articles/PMC10196184/ /pubmed/37215180 http://dx.doi.org/10.3389/fphys.2023.1125340 Text en Copyright © 2023 Zhang, Li, Zhang, Yang, Kong, Chen, Zhang, Liu, Chen, Ye and Wang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Zhang, Jie
Li, Feng
Zhang, Zhi-Yuan
Yang, Fan
Kong, Qi
Chen, Jia-Yi
Zhang, Lei
Liu, Huan-Huan
Chen, Xu-Fei
Ye, Yu-Heng
Wang, Ru-Xing
Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies
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 Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196184/
https://www.ncbi.nlm.nih.gov/pubmed/37215180
http://dx.doi.org/10.3389/fphys.2023.1125340
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