AI Article Synopsis
- This study explores whether conduction system pacing (CSP) can be an effective alternative to biventricular pacing (BiVP) for patients with heart failure needing cardiac resynchronization therapy (CRT).
- The research included 238 patients, assessing outcomes like echocardiographic improvements, and found that CSP resulted in a higher proportion of responders, with 74% showing significant improvement in heart function compared to 60% in the BiVP group.
- While CSP was associated with better left ventricular ejection fraction outcomes, there were no significant differences in hospitalization rates or overall survival between the two groups, indicating that further large-scale studies are necessary to confirm these findings.
Article Abstract
Background: Whether conduction system pacing (CSP) is an alternative option for cardiac resynchronization therapy (CRT) in patients with heart failure remains an area of active investigation.
Objective: The purpose of this study was to assess the echocardiographic and clinical outcomes of CSP compared to biventricular pacing (BiVP).
Methods: This multicenter retrospective study included patients who fulfilled CRT indications and received CSP. Patients with CSP were matched using propensity score matching and compared in a 1:1 ratio to patients who received BiVP. Echocardiographic and clinical outcomes were assessed. Response to CRT was defined as an absolute increase of ≥5% in left ventricular ejection fraction (LVEF) at 6 months post-CRT.
Results: A total of 238 patients were included. Mean age was 69.8 ± 12.5 years, and 66 (27.7%) were female. Sixty-nine patients (29%) had His-bundle pacing, 50 (21%) had left bundle branch area pacing, and 119 (50%) had BiVP. Mean follow-up duration in the CSP and BiVP groups was 269 ± 202 days and 304 ± 262 days, respectively (P = .293). The proportion of CRT responders was greater in the CSP group than in the BiVP group (74% vs 60%, respectively; P = .042). On Kaplan-Meier analysis, there was no statistically significant difference in the time to first heart failure hospitalization (log-rank P = .78) and overall survival (log-rank P = .68) between the CSP and BiVP groups.
Conclusion: In patients with heart failure and reduced ejection fraction, CSP resulted in greater improvement in LVEF compared to BiVP. Large-scale randomized trials are needed to validate these outcomes and further investigate the different options available for CSP.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10225322 | PMC |
| http://dx.doi.org/10.1016/j.hrthm.2023.02.018 | DOI Listing |
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