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Titel: Outcomes of left bundle branch area pacing compared to His bundle pacing as a primary pacing strategy: Systematic review and meta-analysis
VerfasserIn: Abdin, Amr
Werner, Christian
Burri, Haran
Merino, José L.
Vukadinović, Davor
Sawan, Noureddin
Gajek, Jacek
Böhm, Michael
Ukena, Christian
Sprache: Englisch
Titel: Pacing and Clinical Electrophysiology
Bandnummer: 46
Heft: 11
Seiten: 1315-1324
Verlag/Plattform: Wiley
Erscheinungsjahr: 2023
Freie Schlagwörter: cardiac pacing
clinical outcomes
His-bundle pacing
left bundle branch pacing
meta-analysis
systematic review
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Background: Novel pacing technologies, such as His bundle pacing (HBP) and left bundle branch area pacing (LBBaP), have emerged to maintain physiological ventricular activation. We investigated the outcomes of LBBP with HBP for patients requiring a de novo permanent pacing. Methods and Results: Systematic review of randomized clinical trials and observational studies comparing LBBaP with HBP until March 01, 2023 was performed. Random and fixed effects meta-analyses of the effect of pacing technology on outcomes were performed. Study outcomes included pacing metrics, QRS duration, lead revision, procedure parameters, all-cause mortality and heart failure hospitalization (HFH). Overall, 10 studies with 1596 patients were included. Implant success rate was higher in LBBaP compared with HBP (RR 1.24, 95% CI: 1.08 to 1.42, p = .002). LBBaP was associated with lower capture threshold at implantation (mean difference (MD) −0.62 V, 95% CI: −0.74 to −0.51 V, p < .0001) and at follow-up (MD −0.74 V, 95% CI: −0.96 to −0.53, p < .0001), shorter procedure duration (MD −14.66 min, 95% CI: −23.54 to −5.78, p = .001) and shorter fluoroscopy time (MD −4.2 min, 95% CI: −8.4 to −0.0, p = .05). Compared with HBP, LBBaP was associated with a decreased risk of all-cause mortality (RR: 0.50, 95% CI: 0.33 to 0.77, p = .002) and HFH (RR: 0.57, 95% CI: 0.33 to 1.00, p = .05). No statistical differences were found in lead revisions and QRS duration before and after pacing. Conclusion: This meta-analysis found that LBBaP was superior to HBP regarding pacing metrics and implant success rate as an initial pacing strategy, although absence of head-to-head randomized comparison warrants caution in interpretation of the results.
DOI der Erstveröffentlichung: 10.1111/pace.14836
URL der Erstveröffentlichung: https://onlinelibrary.wiley.com/doi/full/10.1111/pace.14836
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-421695
hdl:20.500.11880/37847
http://dx.doi.org/10.22028/D291-42169
ISSN: 1540-8159
0147-8389
Datum des Eintrags: 11-Jun-2024
Bezeichnung des in Beziehung stehenden Objekts: Supporting Information
In Beziehung stehendes Objekt: https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1111%2Fpace.14836&file=pace14836-sup-0001-SuppMat.docx
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Innere Medizin
Professur: M - Prof. Dr. Michael Böhm
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes



Diese Ressource wurde unter folgender Copyright-Bestimmung veröffentlicht: Lizenz von Creative Commons Creative Commons