Comparative efficacy of baroreflex activation therapy, cardiac contractility modulation, and cardiac resynchronization therapy in heart failure with reduced ejection fraction: a systematic review and network meta-analysis of randomized controlled trials.
Indranill Basu-Ray, Roy Arokiam Daniel, Sandeep Ajoy Saha et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and network meta-analysis evaluated the efficacy of baroreflex activation therapy (BAT), cardiac contractility modulation (CCM), and cardiac resynchronization therapy (CRT) in adults with heart failure and reduced ejection fraction (HFrEF). Among 19 trials with 10,125 participants, BAT showed the highest ranking for improvements in left ventricular ejection fraction (LVEF), health-related quality of life, and exercise capacity, while none of the therapies significantly reduced all-cause mortality.
Key findings
- BAT ranked highest for improvement in LVEF, HRQoL, six-minute walk distance, and NYHA class.
- CRT demonstrated the greatest improvement in peak oxygen consumption.
- CCM ranked best for reducing heart failure-related hospitalization.
- None of the device therapies significantly reduced all-cause mortality.
Why it matters
Understanding the comparative effectiveness of these device-based therapies can guide clinicians in selecting appropriate interventions for patients with HFrEF, potentially improving patient outcomes and quality of life.