His-Purkinje conduction system pacing for pacing-induced cardiomyopathy: a systematic literature review and meta-analysis

Zheng, Ran; Yao, Hongxia; Lian, Liyou

doi:10.1007/s10840-022-01296-9

Cited by 12 publications

(4 citation statements)

References 38 publications

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“…Notably, a wider baseline QRS complex has also been found to be significant in determining PICM, with an increased incidence of PICM with a paced QRS duration > 150 ms [1]. Albeit this finding has been identified in studies with small sample sizes and insufficient follow-up durations [14], these results lend itself to the clinical utility of electrocardiography as a non-invasive tool to identify QRS duration as a parameter of synchronous ventricular activation.…”

Section: Factors Associated With High Vp%mentioning

confidence: 89%

“…In order to mitigate this complication and the incidence of PICM, left bundle branch area pacing (LBBAP) has gained widespread attention as an alternative strategy. The potential benefits of LBBAP in those with cardiac resynchronization therapy (CRT) indications are evident, with comparatively narrower QRS complexes leading to rapid LV activation times and specific targeting of the intrinsic conduction pathway optimizing resynchronisation and thus, promoting reverse remodeling [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Optimizing Patient Selection for Physiological Pacing in Bradyarrhythmia: Factors Associated With High Ventricular Pacing Burden

Mannion,

Hong,

Hennessey

et al. 2024

Cardiol Res

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Background: Right ventricular (RV) pacing is established as the most common ventricular pacing (VP) strategy for patients with symptomatic bradyarrhythmia. Some patients with high VP burden suffer deterioration of left ventricular (LV) function, termed pacinginduced cardiomyopathy (PICM). Patients who pace > 20% of the time from the RV apex are at increased risk of PICM, but independent predictors of increased RV pacing burden have not been elucidated in those who have a permanent pacemaker (PPM) inserted for bradyarrhythmia. Methods:We aimed to identify factors that are associated with increased VP burden > 20%, hence determining those at risk for resultant PICM. In this retrospective cohort study, we identified the most recent 300 consecutive cardiac implantable electronic device (CIED) implants in our center and collected past medical history, electrocardiogram (ECG), echo, medication and pacemaker check data.Results: A total of 236 individuals met inclusion criteria. Of the patients, 35% had RV pacing burden < 20%, while 65% had VP burden ≥ 20%; 96.2% of patients with complete heart block (CHB) paced > 20% (P = 0.002). Utilization of DDD or VVI (75.2% and 89.2% of patients, respectively) without mode switch algorithms was associated with VP > 20% (P < 0.001). Male or previous coronary artery bypass grafting (CABG) patients also statistically paced > 20%. Other factors trending towards significance included prolonged PR interval, atrial fibrillation or more advanced age. Conclusion:High-grade atrioventricular (AV) block was associated with an RV pacing burden > 20% over 3 years but this was not consistent in patients with only transient episodes of high-grade AV block. We found a significant association between high VP% and male sex, previous CABG and the absence of mode switching algorithms.

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Section: Factors Associated With High Vp%mentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Optimizing Patient Selection for Physiological Pacing in Bradyarrhythmia: Factors Associated With High Ventricular Pacing Burden

Mannion,

Hong,

Hennessey

et al. 2024

Cardiol Res

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“…In contrast, HPCSP achieves physiological pacing by agitating the endogenous conduction system of the heart to avoid cardiac desynchronization and left ventricular dysfunction, thereby restoring the normal sequence of right and left ventricular excitation, and has received extensive attention from experts and scholars at home and abroad ( 38 – 40 ).…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of His-Purkinje system pacing in the treatment of patients with atrial fibrillation and heart failure: a systematic review and meta-analysis

Guan,

Wang,

Guan

et al. 2023

Front. Cardiovasc. Med.

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AimTo evaluate the safety and efficacy of the His-Purkinje system pacing (HPCSP) in the treatment of individuals with atrial fibrillation (AF) complicated by heart failure (HF).MethodsThe PubMed, Cochrane Library, Web of Science, and Embase databases were searched through September 1, 2022. The literature was initially screened based on the inclusion and exclusion criteria. The baseline characteristics of the subjects, implantation success rate, New York Heart Association (NYHA) classification, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), QRS duration, pacing threshold, and impedance were extracted and summarized; statistical analysis was performed using RevMan 5.3 software.ResultsIn all, 22 articles were included, involving 1,445 patients. Compared to biventricular pacing (BiVP), HPCSP resulted in improved cardiac function, including increased ejection fraction (MD = 5.69, 95% CI: 0.78–10.60, P = 0.02) and decreased LVEDd (MD = −3.50, 95% CI: −7.05–0.05, P = 0.05). It was also correlated with shorter QRS duration (MD = −38.30, 95% CI: −60.71–−15.88, P < 0.01) and reduced all-cause mortality and rehospitalization events (RR = 0.72, 95% CI: 0.57–0.91, P < 0.01) in patients. Left bundle branch pacing (LBBP) lowered the pacing threshold (MD = 0.47; 95% CI: 0.25–0.69; P < 0.01), and there was no statistical difference in the rate of endpoint events when comparing these two physiologic pacing modalities (RR = 1.56, 95% CI: 0.87–2.80, P = 0.14).ConclusionThe safety and efficacy of HPCSP in patients with AF and HF were verified in this meta-analysis. HPCSP can reverse cardiac remodeling and has great clinical application value. Relatively speaking, His-bundle pacing (HBP) can maintain better ventricular electro-mechanical synchronization, and the pacing parameters of LBBP are more stable.Systematic Review RegistrationPROSPERO (CRD42022336109)

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“…A systematic review and meta-analysis of early HBP literature for patients who underwent device upgrade from conventional RV pacing to HBP for documented pacing-induced cardiomyopathy has been published by Zheng et al [100]. This included 6 studies with a total of 144 patients.…”

Section: His Bundle Pacingmentioning

confidence: 99%

Paradigm Shifts in Cardiac Pacing: Where Have We Been and What Lies Ahead?

Ballantyne

Chew

Vandenberk

2023

JCM

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The history of cardiac pacing dates back to the 1930s with externalized pacing and has evolved to incorporate transvenous, multi-lead, or even leadless devices. Annual implantation rates of cardiac implantable electronic devices have increased since the introduction of the implantable system, likely related to expanding indications, and increasing global life expectancy and aging demographics. Here, we summarize the relevant literature on cardiac pacing to demonstrate the enormous impact it has had within the field of cardiology. Further, we look forward to the future of cardiac pacing, including conduction system pacing and leadless pacing strategies.

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His-Purkinje conduction system pacing for pacing-induced cardiomyopathy: a systematic literature review and meta-analysis

Cited by 12 publications

References 38 publications

Optimizing Patient Selection for Physiological Pacing in Bradyarrhythmia: Factors Associated With High Ventricular Pacing Burden

Optimizing Patient Selection for Physiological Pacing in Bradyarrhythmia: Factors Associated With High Ventricular Pacing Burden

Safety and efficacy of His-Purkinje system pacing in the treatment of patients with atrial fibrillation and heart failure: a systematic review and meta-analysis

Paradigm Shifts in Cardiac Pacing: Where Have We Been and What Lies Ahead?

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