Left bundle branch pacing versus biventricular pacing for cardiac resynchronization therapy: A systematic review and meta‐analysis.
Introduction: Cardiac resynchronization therapy (CRT) reduces heart failure (HF) hospitalization and all‐cause mortality in HF patients with left bundle branch block (LBBB). Biventricular pacing (BVP) is the gold standard for achieving CRT, but about 30%–40% of patients do not respond to BVP‐CRT. Re...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 46; no. 5; pp. 432 - 440 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
May2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=163742658&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 163742658 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: May2023 vid: 46 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 163742658 162988028 163742658 163742658 10.1111/pace.14700 163742658 ppf: 432 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Left bundle branch pacing versus biventricular pacing for cardiac resynchronization therapy: A systematic review and meta‐analysis. aug: au: Parlavecchio, Antonio Vetta, Giampaolo Caminiti, Rodolfo Coluccia, Giovanni Magnocavallo, Michele Ajello, Manuela Pistelli, Lorenzo Dattilo, Giuseppe Foti, Rosario Carerj, Scipione Della Rocca, Domenico Giovanni Crea, Pasquale Palmisano, Pietro affil: Cardiology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy sug: subj: Cardiac Resynchronization Therapy Cardiac Pacing, Artificial Heart Failure Therapy Heart Conduction System Human Systematic Review Meta Analysis Descriptive Statistics Hospitalization Confidence Intervals Medline Cochrane Library ab: Introduction: Cardiac resynchronization therapy (CRT) reduces heart failure (HF) hospitalization and all‐cause mortality in HF patients with left bundle branch block (LBBB). Biventricular pacing (BVP) is the gold standard for achieving CRT, but about 30%–40% of patients do not respond to BVP‐CRT. Recent studies showed that left bundle branch pacing (LBBP) provided remarkable results in CRT. Therefore, we conducted a meta‐analysis aiming to compare LBBP‐CRT versus BVP‐CRT in HF patients. Methods: We systematically searched the electronic databases for studies published from inception to December 29, 2022 and focusing on LBBP‐CRT versus BVP‐CRT in HF patients. The primary endpoint was HF hospitalization. The effect size was estimated using a random‐effect model as Risk Ratio (RR) and mean difference (MD). Results: Ten studies enrolling 1063 patients met the inclusion criteria. Compared to BVP‐CRT, LBBP‐CRT led to significant reduction in HF hospitalization [7.9% vs.14.5%; RR: 0.60 (95%CI: 0.39–0.93); p =.02], QRSd [MD: 30.26 ms (95%CI: 26.68–33.84); p <.00001] and pacing threshold [MD: −0.60 (95%CI: −0.71 to −0.48); p <.00001] at follow up. Furthermore, LBBP‐CRT improved LVEF [MD: 5.78% (95%CI: 4.78–6.77); p <.00001], the rate of responder [88.5% vs.72.5%; RR: 1.19 (95%CI: 1.07–1.32); p =.002] and super‐responder [60.8% vs. 36.5%; RR: 1.56 (95%CI: 1.27–1.91); p <.0001] patients and the NYHA class [MD: −0.42 (95%CI: −0.71 to −0.14); p <.00001] compared to BVP‐CRT. Conclusion: In HF patients, LBBP‐CRT was superior to BVP‐CRT in reducing HF hospitalization. Further significant benefits occurred within the LBBP‐CRT group in terms of QRSd, LVEF, pacing thresholds, NYHA class and the rate of responder and super‐responder patients. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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