Beyond biventricular pacing: Exploring the advantages of his‐bundle pacing and left bundle branch pacing in heart failure—A systematic review and meta‐analysis.
Background: This meta‐analysis compares His‐Purkinje system pacing (HPSP), a novel cardiac resynchronization therapy (CRT) technique that targets the intrinsic conduction system of the heart, with conventional biventricular pacing (BiVP) in heart failure (HF) patients with left ventricular (LV) dysf...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 47; no. 1; pp. 156 - 167 |
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| Autores principales: | , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jan2024
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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=174713365&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 174713365 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Jan2024 vid: 47 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 174713365 174056954 174713365 174713365 10.1111/pace.14892 174713365 ppf: 156 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Beyond biventricular pacing: Exploring the advantages of his‐bundle pacing and left bundle branch pacing in heart failure—A systematic review and meta‐analysis. aug: au: Al Hennawi, Hussam Khan, Muhammad Khuzzaim Khalid, Momina Khalid, Hiba Fatima, Laveeza Ashraf, Muhammad Talal Bhimani, Sameer Pavri, Behzad B. affil: Department of Internal Medicine, Jefferson Abington Hospital, Abington, Philadelphia, USA sug: subj: Heart Failure Therapy Cardiac Pacing, Artificial Methods Cardiac Resynchronization Therapy Methods Bundle of HIS Bundle-Branch Block Treatment Outcomes Human Systematic Review Meta Analysis Confidence Intervals Descriptive Statistics Scales PubMed Embase Cochrane Library Odds Ratio Hospitalization Evaluation ab: Background: This meta‐analysis compares His‐Purkinje system pacing (HPSP), a novel cardiac resynchronization therapy (CRT) technique that targets the intrinsic conduction system of the heart, with conventional biventricular pacing (BiVP) in heart failure (HF) patients with left ventricular (LV) dysfunction and dyssynchrony. Methods: We searched multiple databases up to May 2023 and identified 18 studies (five randomized controlled trials and 13 observational studies) involving 1291 patients. The outcome measures were QRS duration, left ventricular ejection fraction (LVEF) improvement, left ventricular end‐diastolic diameter (LVEDD) change, HF hospitalization, and New York Heart Association (NYHA) functional class improvement. We used a random‐effects model to calculate odds ratios (OR), and mean differences (MD) with 95% confidence intervals (CI). We also assessed the methodological quality of the studies. Results: The mean LVEF was 30.7% and the mean follow‐up duration was 8.1 months. Among LBBP, HBP, and BiVP, HBP provided the shortest QRS duration [MD: −18.84 ms, 95% CI: −28.74 to −8.94; p = 0.0002], while LBBP showed the greatest improvement in LVEF [MD: 5.74, 95% CI: 2.74 to 7.46; p < 0.0001], LVEDD [MD: −5.55 mm, 95% CI: −7.51 to −3.59; p < 0.00001], and NYHA functional class [MD: −0.58, 95% CI: −0.80 to −‐0.35; p < 0.00001]. However, there was no significant difference in HF hospitalization between HPSP and BiVP. Conclusion: LBBP as modality of HPSP demonstrated superior outcomes in achieving electrical ventricular synchrony and systolic function, as well as alleviating HF symptoms, compared to other pacing techniques. 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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