Conduction System Pacing vs Right Ventricular Pacing in Preserved or Mildly Reduced Ejection Fraction: A Meta-Analysis of Randomised Trials.
Abdalhakim Shubietah, Mohamed Saad Rakab, Elsayed Balbaa et al.
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In 30 seconds
This meta-analysis of 15 randomized controlled trials involving 1466 patients with preserved or mildly reduced left ventricular ejection fraction compared conduction system pacing (CSP) to right ventricular pacing (RVP). CSP significantly reduced pacing-induced cardiomyopathy (4.6% vs 16.2%; RR 0.34) and heart failure hospitalizations (3.3% vs 9.1%; RR 0.34), while improving left ventricular ejection fraction by 2.96%.
Key findings
- CSP reduced pacing-induced cardiomyopathy to 4.6% compared to 16.2% with RVP (RR 0.34).
- Heart failure hospitalization rates were lower with CSP at 3.3% versus 9.1% for RVP (RR 0.34).
- CSP improved left ventricular ejection fraction by 2.96% compared to RVP.
- CSP had a lower pacing success rate of 93.6% compared to 99.5% for RVP.
Why it matters
The findings suggest that conduction system pacing may offer significant benefits in reducing complications associated with ventricular pacing in patients with preserved or mildly reduced ejection fraction, potentially leading to better long-term outcomes.