Conduction System Pacing Versus Right Ventricular Pacing in Patients With Atrioventricular Block and Anticipated High Pacing Burden.
Am J CardiolJul 22, 2026 (epub)
Clinical ResearchCardiology
Shreyas Singireddy, Sami Shoura, Darshine Venugopal et al.
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In 30 seconds
This meta-analysis evaluated the effects of conduction system pacing (CSP) versus right ventricular pacing (RVP) in patients with atrioventricular block and high pacing burden. Analyzing data from five randomized controlled trials involving 806 patients, CSP significantly reduced the incidence of pacing-induced cardiomyopathy (PICM) (HR 0.30) and preserved left ventricular ejection fraction (ΔLVEF +4.41%) compared to RVP.
Key findings
- CSP reduced the incidence of pacing-induced cardiomyopathy (PICM) with a hazard ratio of 0.30.
- CSP was associated with a mean difference in left ventricular ejection fraction of +4.41%.
- CSP significantly reduced heart failure hospitalizations with a hazard ratio of 0.24.
- CSP shortened paced QRS duration by a mean difference of -27.5 ms.
Why it matters
The findings suggest that conduction system pacing may be a superior strategy for patients with atrioventricular block and high pacing burden, potentially reducing the risk of pacing-induced cardiomyopathy and improving heart function.