Cardiac resynchronization therapy in non-ischemic cardiomyopathy: a comparative non-randomized study of His Bundle pacing versus biventricular pacing

Moriña‐Vázquez, Pablo; Salas, María Teresa Moraleda; Rodríguez-Albarrán, Adrián; Arce-León, Álvaro; Venegas‐Gamero, José; Fernández-Gómez, Juan Manuel; Esteve-Ruiz, Irene; Barba-Pichardo, Rafael

doi:10.1007/s10840-022-01192-2

Cited by 8 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The systematic search identified 37 eligible publications, 4–8,18–49 including 20 comparative studies—among which four were randomized controlled trials—and 17 single‐arm investigations reporting outcomes in patients undergoing CSP for CRT (details shown in Figure 1). The comparative studies enabled network meta‐analyses of the three interventions—His‐CRT, LBB‐CRT, and BiV‐CRT.…”

Section: Resultsmentioning

confidence: 99%

“…The incidence of death and hospitalization were reported, and compared between CSP-CRT and BiV-CRT in 15 studies 4,5,7,8,21,22,27,31,[37][38][39][42][43][44]49 and 12 studies, 4,5,7,21,27,31,[37][38][39]42,44,49 respectively. The relative risk of death was 0.75 (95% CI: [0.61-0.91]; p = .008; I 2 = 0%; Supporting Infomation: Figure S24).…”

Section: Clinical Responsementioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of conduction system pacing for cardiac resynchronization therapy: A systematic review and network meta‐analysis

Tavolinejad,

Kazemian,

Bozorgi

et al. 2023

Cardiovasc electrophysiol

View full text Add to dashboard Cite

IntroductionCardiac 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 ResultsThe 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]).ConclusionThis 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.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Clinical Responsementioning

confidence: 99%

Effectiveness of conduction system pacing for cardiac resynchronization therapy: A systematic review and network meta‐analysis

Tavolinejad,

Kazemian,

Bozorgi

et al. 2023

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…A total of five confounding factors were screened, including study design (multi-center and single-center), CSP sample size (>20 and ≤20), male proportion (>50% and ≤50%), CSP types (LBBaP and HBP), and follow-up (≥12 months and <12 months). 2019; Guo et al, 2020;Li et al, 2020;Wang et al, 2020;Liu et al, 2021a;Vinther et al, 2021;Wu et al, 2021;Hua et al, 2022a;Chen et al, 2022;Moriña-Vázquez et al, 2022;Rademakers et al, 2022;Vijayaraman et al, 2022;Wang et al, 2022) the flowchart of study selection is displayed in Figure 1. The baseline characteristics of the eligible studies were presented in Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…The baseline characteristics of the eligible studies were presented in Table 1. Four of fifteen eligible studies were randomized controlled studies (Lustgarten et al, 2015;Upadhyay et al, 2019b;Vinther et al, 2021;Wang et al, 2022), and the literature quality was evaluated with the Cochrane's Risk of Bias Tool (Supplementary Figure S1); meanwhile, the remaining eleven non-randomized studies (Vijayaraman et al, 2019;Guo et al, 2020;Li et al, 2020;Wang et al, 2020;Liu et al, 2021a;Wu et al, 2021;Hua et al, 2022a;Chen et al, 2022;Moriña-Vázquez et al, 2022;Rademakers et al, 2022;Vijayaraman et al, 2022) were evaluated with the Newcastle-Ottawa Scale (NOS) (Supplementary Table S1). The quality of all the studies were good.…”

Section: Discussionmentioning

confidence: 99%

“…There is a total of five studies (Guo et al, 2020;Li et al, 2020;Wang et al, 2020;Vinther et al, 2021;Rademakers et al, 2022) reported clinical response rate, eight (Guo et al, 2020;Li et al, 2020;Wang et al, 2020;Liu et al, 2021a;Chen et al, 2022;Moriña-Vázquez et al, 2022;Rademakers et al, 2022;Wang et al, 2022) reported echo response rate and five (Li et al, 2020;Wu et al, 2021;Hua et al, 2022a;Chen et al, 2022;Moriña-Vázquez et al, 2022) for super response rate. The average time of observation was 6 months, 7.3 ± 3.0 months and 13.2 ± 6.6 months for clinical response rate, echo response rate and super response rate individually.…”

Section: Pacing Thresholds Clinical Response Rate Echo Response Rate ...mentioning

confidence: 99%

See 1 more Smart Citation

Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies

Zhang

et al. 2023

Front. Physiol.

View full text Add to dashboard Cite

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.

show abstract

His bundle pacing success and electrical parameter stability regardless of three-dimensional transthoracic echocardiography lead localization

Moriña‐Vázquez

Esteve-Ruiz

Salas

et al. 2023

J Interv Card Electrophysiol

View full text Add to dashboard Cite

Cardiac resynchronization therapy in non-ischemic cardiomyopathy: a comparative non-randomized study of His Bundle pacing versus biventricular pacing

Cited by 8 publications

References 14 publications

Effectiveness of conduction system pacing for cardiac resynchronization therapy: A systematic review and network meta‐analysis

Effectiveness of conduction system pacing for cardiac resynchronization therapy: A systematic review and network meta‐analysis

Conduction system pacing is superior to biventricular pacing in patients with heart failure: Insights from the pooled clinical studies

His bundle pacing success and electrical parameter stability regardless of three-dimensional transthoracic echocardiography lead localization

Contact Info

Product

Resources

About