Conduction system pacing vs biventricular pacing for cardiac resynchronization therapy: Frequentist and Bayesian meta-analysis of randomized controlled trials and propensity-matched studies.
Heart RhythmJul 4, 2026 (epub)
Clinical ResearchCardiology
Raymond Pranata, Wilbert Huang, Christopher Daniel Tristan et al.
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In 30 seconds
This meta-analysis compared conduction system pacing (CSP) to biventricular (BiV) pacing for cardiac resynchronization therapy (CRT) in 5524 patients across 28 studies, including 13 randomized controlled trials. CSP was associated with a better CRT response (odds ratio 1.69) and lower odds of heart failure hospitalization (odds ratio 0.58) and all-cause mortality (odds ratio 0.67).
Key findings
- CSP was associated with a better CRT response (OR, 1.69; P = .0027).
- CSP showed lower odds of heart failure hospitalization (OR, 0.58; P = .0347).
- CSP was linked to reduced all-cause mortality (OR, 0.67; P = .0340).
- Bayesian analysis indicated over 90% probability of meaningful benefit for several outcomes with CSP.
Why it matters
The findings suggest that CSP may improve clinical outcomes in patients receiving CRT compared to traditional BiV pacing, which could influence treatment strategies in heart failure management.