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• W4377015845 abstract "Cardiac conduction system pacing, in the form of His-Cardiac Resynchronization therapy (His-CRT), is advantageous due to its physiological nature and accompanying clinical benefits.His-CRT has not become mainstream practice, due to challenges such as higher procedural time, pacing thresholds and varying success rates. There is a paucity of studies comparing His-CRT with other pacing modalities such as Left Bundle Branch Paced-Cardiac Resynchronization Therapy (LBBP-CRT) or Bi-Ventricular-Cardiac Resynchronization Therapy(BiV-CRT). To investigate clinical and electrophysiologic outcomes in patients receiving His-CRT as compared to LBBP-CRT or BiV-CRT. We performed a systematic search of the PubMed, EMBASE, and Scopus databases to identify studies comparing patients receiving His-CRT and LBBP-CRT or BiV-CRT for appropriate indications. Eight studies were included in the final analysis. The outcomes studied were differences in ejection fraction (EF), QRS duration, capture threshold and ventricular impedance at baseline and at follow-up. A frequentist network meta-analysis model was used. We used netmeta module and random effects model in CRAN-R software to compute pooled standard mean differences across all outcomes. Higgin’s I2 statistic was used to evaluate heterogeneity. Results are reported using His-CRT as a reference treatment. Pooled Standard Mean Difference (SMD) for follow-up EF for BiV-CRT in comparison to His-CRT was - 5.66% (95% CI: -10.6 to - 0.73; p-value = 0.024) while for LBBP-CRT in comparison His-CRT was -0.87% (95% CI: -5.53 to 3.79; p-value = 0.714). Pooled SMD for follow-up QRS for BiV-CRT in comparison to His-CRT was 13.96 ms (95% CI: 4.21 to 23.70; p-value = 0.005) while for LBBP-CRT in comparison to His-CRT was 1.27 ms (95% CI: -4.789 to 7.346; p-value = 0.679). Pooled SMD for follow-up capture threshold for BiV-CRT in comparison to His-CRT was 1.03 V (95% CI: 0.69 to 1.375; p-value < 0.0001) while for LBBP-CRT in comparison to His-CRT was 0.677 V (95% CI: 0.504 to 0.8501; p-value < 0.0001). Pooled SMD for follow-up ventricular impedance for BiV-CRT in comparison to His-CRT was -281.25 Ohms (95% CI: - 380.24 to - 182.25; p-value < 0.0001) while for LBBP-CRT in comparison to His-CRT was -41.33 Ohms (95% CI: - 101.059 to 18.393; p-value = 0.1750). His-CRT was associated with better outcomes for most measured parameters compared to BiV-CRT. LBBP-CRT was comparable to His-CRT. Prospective trials are needed to further substantiate our findings." @default.
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• W4377015845 date "2023-05-01" @default.
• W4377015845 modified "2023-09-26" @default.
• W4377015845 title "PO-02-044 HIS CARDIAC RESYNCHRONIZATION THERAPY: A NETWORK META-ANALYSIS" @default.
• W4377015845 doi "https://doi.org/10.1016/j.hrthm.2023.03.837" @default.
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