Evidence map›Paper›PMID 30010807›Full record

SynthesisCardiovascular research2018

Cardiac resynchronization is pro-arrhythmic in the absence of reverse ventricular remodelling: a systematic review and meta-analysis.

Bishoy Deif, Brennan Ballantyne, Fahad Almehmadi, Michael Mikhail, William F McIntyre, Jaimie Manlucu, Raymond Yee, John L Sapp, Jason D Roberts, Jeff S Healey and 2 more

Registry-linked trialOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Cardiovascular research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05155865 (Conduction System Pacing Versus Biventricular Pacing for Cardiac ResYNChronization), which is not on this map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05155865 nacompletednot on this mapstarted 2022, after this paper: background citation

Conduction System Pacing Versus Biventricular Pacing for Cardiac ResYNChronization (CSP-SYNC)

TypeinterventionalSponsorUniversity Medical Centre LjubljanaRan2022 to 2024Enrolled62ConditionsDilated Cardiomyopathy with Conduction Defect, Left Bundle-Branch Block, Heart Failure, Resynchronization TherapyArmsResynchronization with conduction system pacing, Cardiac resynchronization therapy with biventricular stimulation
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 39 citations in OpenAlex.

  1. Predicting Ventricular Tachyarrhythmias in Patients With Left Ventricular Ejection Fraction Improvement Following Cardiac Resynchronization Therapy.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2025
    Trial
  2. Risk factors for ventricular tachyarrhythmic events in patients without left bundle branch block who receive cardiac resynchronization therapy.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2021
    Trial
  3. Review
  4. Article
  5. Review
  6. Review
  7. Review
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  10. Age-stratified comparison of prognosis in cardiac resynchronization therapy with or without prophylactic defibrillator for nonischemic cardiomyopathy-a nationwide cohort study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  11. Review
  12. Article
  13. Review
  14. Chronically altered ventricular activation causes pro-arrhythmic cardiac electrical remodelling in the chronic AV block dog model.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  15. Article
  16. Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Bishoy DeifDivision of Cardiology, Department of Medicine, Western University, 339 Windermere Road, London, Ontario, Canada.
Brennan BallantyneDivision of Cardiology, Department of Medicine, Western University, 339 Windermere Road, London, Ontario, Canada.
Fahad AlmehmadiDivision of Cardiology, Department of Medicine, Western University, 339 Windermere Road, London, Ontario, Canada.
Michael MikhailSchool of Biomedical Sciences, Department of Graduate Studies, Rowan University, Stratford, New Jersey, USA.
William F McIntyrePopulation Health Research Institute & Division of Cardiology, Department of Medicine McMaster University, Hamilton, Canada.
Jaimie ManlucuDivision of Cardiology, Department of Medicine, Western University, 339 Windermere Road, London, Ontario, Canada.
Raymond YeeDivision of Cardiology, Department of Medicine, Western University, 339 Windermere Road, London, Ontario, Canada.
John L SappDepartment of Medicine, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada.
Jason D RobertsDivision of Cardiology, Department of Medicine, Western University, 339 Windermere Road, London, Ontario, Canada.
Jeff S HealeyPopulation Health Research Institute & Division of Cardiology, Department of Medicine McMaster University, Hamilton, Canada.
Peter Leong-SitDivision of Cardiology, Department of Medicine, Western University, 339 Windermere Road, London, Ontario, Canada.
Anthony S TangDivision of Cardiology, Department of Medicine, Western University, 339 Windermere Road, London, Ontario, Canada.
Western University · CAMcMaster University · CADalhousie University · CARowan University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Cardiac resynchronization therapy (CRT) has been shown to reduce mortality and heart failure (HF) hospitalization but its effects on the rate of ventricular arrhythmias (VAs) appears to be neutral. We hypothesize that CRT with LV epicardial stimulation is inherently pro-arrhythmic and increases VA rates in the absence of reverse ventricular remodelling while conferring an anti-arrhythmic effect in mechanical responders. Methods and results: In this systematic review and meta-analysis, we considered retrospective cohort, prospective cohort, and randomized controlled trials comparing VA rates between cardiac resynchronization therapy-defibrillator (CRT-D) non-responders, CRT-D responders and those with implantable cardioverter-defibrillator (ICD) only. Studies were eligible if they defined CRT-D responders using a discrete left ventricular volumetric value as assessed by any imaging modality. Studies were identified through searching electronic databases from their inception to July 2017. We identified 2579 citations, of which 23 full-text articles were eligible for final analysis. Our results demonstrated that CRT-D responders were less likely to experience VA than CRT-D non-responders, relative risk (RR) 0.49 [95% confidence interval (CI) 0.41-0.58, P < 0.01] and also less than patients with ICD only: RR 0.59 (95% CI 0.50-0.69, P < 0.01). However, CRT-D mechanical non-responders had a greater likelihood of VA compared with ICD only, RR 0.76 (95% CI 0.63-0.92, P = 0.004). Conclusion: CRT-D non-responders experienced more VA than CRT-D responders and also more than those with ICD only, suggesting that CRT with LV epicardial stimulation may be inherently pro-arrhythmic in the absence of reverse remodelling.

Indexed as

Electric CountershockVentricular Function, LeftVentricular RemodelingAgedArrhythmias, CardiacCardiac Resynchronization TherapyCardiac Resynchronization Therapy DevicesClinical Decision-MakingDefibrillators, ImplantableFemaleHeart FailureHumansMaleMiddle AgedRisk AssessmentRisk Factors

Identifiers

PMID30010807
OpenAlexW2884236052

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.