Permanent HIS bundle Pacing Feasibility in Routine Clinical Practice: Experience from an Indian Center

Sarkar, Ranu; Kaur, Daljeet; Subramanian, Muthiah; Yalagudri, Sachin; Chennapragada, Sridevi; Devidutta, Soumen; Bera, Debabrata; Narasimhan, Calambur

doi:10.1016/j.ihj.2019.09.003

Cited by 6 publications

(9 citation statements)

References 15 publications

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“…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 ).…”

Section: Resultsmentioning

confidence: 96%

“…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.…”

Section: Resultsmentioning

confidence: 99%

“…The single‐arm data were used to pool outcome measures in patients undergoing CSP. Eight studies presented patient‐level data for outcomes 25,26,29,32,40,45,47,48 . Durations of follow‐up ranged between 5 and 31 months, with most studies (25/37) following patients between 6 and 12 months.…”

Section: Resultsmentioning

confidence: 99%

“…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 .…”

Section: Resultsmentioning

confidence: 99%

“…Pacing thresholds of the His, LBB, or left ventricular (LV) leads were recorded in 26 studies 4,5,7,18–26,29,31,32,34–40,44,47–49 . At the time of implant, the pooled pacing threshold was 1.4 V (95% CI: [1.0–2.1]; I 2 = 89%) for His‐CRT, 0.7 V (95% CI: [0.6–0.8]; I 2 = 95%) for LBB‐CRT, and 1.1 V (95% CI: [0.9–1.3]; I 2 = 98%) for the LV lead in the BiV‐CRT group (Supporting Information: Figures ).…”

Section: Resultsmentioning

confidence: 99%

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

Tavolinejad,

Kazemian,

Bozorgi

et al. 2023

Cardiovasc electrophysiol

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IntroductionCardiac resynchronization therapy (CRT) with biventricular pacing (BiV‐CRT) is ineffective in approximately one‐third of patients. CRT with Conduction system pacing (CSP‐CRT) may achieve greater synchronization. We aimed to assess the effectiveness of CRT with His pacing (His‐CRT) or left bundle branch pacing (LBB‐CRT) in lieu of biventricular CRT.Methods and ResultsThe PubMed, Embase, Web of Science, Scopus, and the Cochrane Library were systematically searched until August 19, 2023, for original studies including patients with reduced left ventricular ejection fraction (LVEF) who received His‐ or LBB‐CRT, that reported either CSP‐CRT success, LVEF, QRS duration (QRSd), or New York Heart Association (NYHA) classification. Effect measures were compared with frequentist network meta‐analysis. Thirty‐seven publications, including 20 comparative studies, were included. Success rates were 73.5% (95% CI: 61.2–83.0) for His‐CRT and 91.5% (95% CI: 88.0–94.1) for LBB‐CRT. Compared to BiV‐CRT, greater improvements were observed for LVEF (mean difference [MD] for His‐CRT +3.4%; 95% CI [1.0; 5.7], and LBB‐CRT: +4.4%; [2.5; 6.2]), LV end‐systolic volume (His‐CRT:17.2mL [29.7; 4.8]; LBB‐CRT:15.3mL [28.3; 2.2]), QRSd (His‐CRT: –17.1ms [–25.0; –9.2]; LBB‐CRT: –17.4ms [–23.2; –11.6]), and NYHA (Standardized MD [SMD]: His‐CRT:0.4 [0.8; 0.1]; LBB‐CRT:0.4 [–0.7; –0.2]). Pacing thresholds at baseline and follow‐up were significantly lower with LBB‐CRT versus both His‐CRT and BiV‐CRT. CSP‐CRT was associated with reduced mortality (R = 0.75 [0.61–0.91]) and hospitalizations risk (RR = 0.63 [0.42–0.96]).ConclusionThis study found that CSP‐CRT is associated with greater improvements in QRSd, echocardiographic, and clinical response. LBB‐CRT was associated with lower pacing thresholds. Future randomized trials are needed to determine CSP‐CRT efficacy.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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