Please use this identifier to cite or link to this item: doi:10.22028/D291-35419
Title: Outcomes of conduction system pacing compared to right ventricular pacing as a primary strategy for treating bradyarrhythmia: systematic review and meta-analysis
Author(s): Abdin, Amr
Aktaa, Suleman
Vukadinović, Davor
Arbelo, Elena
Burri, Harran
Glikson, Michael
Meyer, Christian
Munyombwe, Theresa
Nielsen, Jens Cosedis
Ukena, Christian
Vernooy, Kevin
Gale, Chris P.
Language: English
Title: Clinical Research in Cardiology
Publisher/Platform: Springer Nature
Year of Publication: 2021
Free key words: Cardiac pacing
His‐bundle pacing
Left bundle branch pacing
Clinical outcomes
Systematic review
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Background Right ventricular pacing (RVP) may cause electrical and mechanical desynchrony leading to impaired left ventricular ejection fraction (LVEF). We investigated the outcomes of RVP with His bundle pacing (HBP) and left bundle branch pacing (LBBP) for patients requiring a de novo permanent pacemaker (PPM) for bradyarrhythmia. Methods and results Systematic review of randomized clinical trials and observational studies comparing HBP or LBP with RVP for de novo PPM implantation between 01 January 2013 and 17 November 2020 was performed. Random and fixed effects meta-analyses of the effect of pacing technology on outcomes were performed. Study outcomes included all-cause mortality, heart failure hospitalization (HFH), LVEF, QRS duration, lead revision, atrial fibrillation, procedure parameters, and pacing metrics. Overall, 9 studies were included (6 observational, 3 randomised). HBP compared with RVP was associated with decreased HFH (risk ratio [RR] 0.68, 95% confidence interval [CI] 0.49–0.94), preservation of LVEF (mean difference [MD] 0.81, 95% CI − 1.23 to 2.85 vs. − 5.72, 95% CI − 7.64 to -3.79), increased procedure duration (MD 15.17 min, 95% CI 11.30–19.04), and increased lead revisions (RR 5.83, 95% CI 2.17–15.70, p = 0.0005). LBBP compared with RVP was associated with shorter paced QRS durations (MD 5.6 ms, 95% CI − 6.4 to 17.6) vs. (51.0 ms, 95% CI 39.2–62.9) and increased procedure duration (MD 37.78 min, 95% CI 20.04–55.51). Conclusion Of the limited studies published, this meta-analysis found that HBP and LBBP were superior to RVP in maintaining physiological ventricular activation as an initial pacing strategy.
DOI of the first publication: 10.1007/s00392-021-01927-7
Link to this record: urn:nbn:de:bsz:291--ds-354199
ISSN: 1861-0692
Date of registration: 7-Feb-2022
Faculty: M - Medizinische Fakultät
Department: M - Innere Medizin
Professorship: M - Keiner Professur zugeordnet
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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