His-bundle pacing versus cardiac resynchronisation therapy: Effect on ECG parameters of repolarization

Effectiveness of conduction system pacing for cardiac resynchronization therapy: A systematic review and network meta‐analysis

“…QRSd was reported in 35 studies (2378 patients) 4–8,18–26,28–42,44–49 . The pooled mean native QRSd of 166.2 ms (95% CI: [162.5–169.9]; I 2 = 96%) was reduced to 123.4 ms (95% CI: [119.2–127.8]; I 2 = 98%) after CSP (Supporting Information: Figure ).…”

“…The systematic search identified 37 eligible publications, 4–8,18–49 including 20 comparative studies—among which four were randomized controlled trials—and 17 single‐arm investigations reporting outcomes in patients undergoing CSP for CRT (details shown in Figure 1). The comparative studies enabled network meta‐analyses of the three interventions—His‐CRT, LBB‐CRT, and BiV‐CRT.…”

“…LVEF measurements before and after CSP were reported in 32 studies (2145 patients), 4–8,18–26,28–35,37–39,41,42,44,45,47–49 showing an overall mean LVEF improvement of +15.4% (95% CI: [13.3–17.5]; I 2 = 95%; Supporting Information: Figure ). LVEF changes were compared between CSP and BVP in 18 studies 4,5,7,8,20–22,24,25,31,33,37–39,41,42,44,49 .…”

“…LVEF measurements before and after CSP were reported in 32 studies (2145 patients), 4–8,18–26,28–35,37–39,41,42,44,45,47–49 showing an overall mean LVEF improvement of +15.4% (95% CI: [13.3–17.5]; I 2 = 95%; Supporting Information: Figure ). LVEF changes were compared between CSP and BVP in 18 studies 4,5,7,8,20–22,24,25,31,33,37–39,41,42,44,49 . Among the comparative studies the pooled LVEF Improvement was +16.7% (95% CI: [13.8–19.6]; I 2 = 96%) in the CSP groups (1563 patients) and +11.5% (95% CI: [9.5–13.5]; I 2 = 89%) after BVP (1734 patients; Supporting Information: Figure ).…”

Depolarization and repolarization dynamics after His‐bundle pacing: Comparison with right ventricular pacing and native ventricular conduction

“…They reported that left bundle branch area pacing yielded a narrower paced QRS duration, shorter QT and QTc interval, lower QT dispersion, and shorter Tpe than RV septal pacing in the acute phase after pacemaker implantation. Recent studies demonstrated the significant benefits of repolarization parameters on ECG after conduction system pacing compared with those after cardiac resynchronization therapy at a mild‐term assessment period of up to 6 weeks or a median of 42 days following implantation (Gupta & Pavri, 2022 ; Sarkar et al, 2022 ). In contrast to previous studies, we implemented a sufficient follow‐up period of 6 months to reduce the effect of ventricular repolarization instability during the acute phase and elicited a continuous advantage of repolarization stability after HBP in the chronic phase.…”