TY - JOUR
T1 - Outcomes of conduction system pacing for cardiac resynchronization therapy in patients with heart failure
T2 - A multicenter experience
AU - Ezzeddine, Fatima M.
AU - Pistiolis, Serafim M.
AU - Pujol-Lopez, Margarida
AU - Lavelle, Michael
AU - Wan, Elaine Y.
AU - Patton, Kristen K.
AU - Robinson, Melissa
AU - Lador, Adi
AU - Tamirisa, Kamala
AU - Karim, Saima
AU - Linde, Cecilia
AU - Parkash, Ratika
AU - Birgersdotter-Green, Ulrika
AU - Russo, Andrea M.
AU - Chung, Mina
AU - Cha, Yong Mei
N1 - Publisher Copyright:
© 2023 Heart Rhythm Society
PY - 2023/6
Y1 - 2023/6
N2 - 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.
AB - 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.
KW - Cardiac resynchronization therapy
KW - Conduction system pacing
KW - Heart failure
KW - His-bundle pacing
KW - Left bundle branch area pacing
KW - Physiological pacing
KW - Ventricular Function, Left/physiology
KW - Cardiac Conduction System Disease/therapy
KW - Humans
KW - Middle Aged
KW - Male
KW - Treatment Outcome
KW - Stroke Volume
KW - Heart Failure/diagnosis
KW - Cardiac Resynchronization Therapy/methods
KW - Electrocardiography/methods
KW - Aged, 80 and over
KW - Female
KW - Aged
KW - Retrospective Studies
UR - http://www.scopus.com/inward/record.url?scp=85151969584&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85151969584&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2023.02.018
DO - 10.1016/j.hrthm.2023.02.018
M3 - Article
C2 - 36842610
AN - SCOPUS:85151969584
SN - 1547-5271
VL - 20
SP - 863
EP - 871
JO - Heart Rhythm
JF - Heart Rhythm
IS - 6
ER -