Evidence map›Paper›PMID 37936674›Full record

ArticleHeart rhythm O22023

Clinical outcomes of automatic algorithms in cardiac resynchronization therapy: Systematic review and meta-analysis.

Leonardo Knijnik, Bo Wang, Rhanderson Cardoso, Colby Shanafelt, Michael S Lloyd

Abstract read
In one paragraph

Article in Heart rhythm O2, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Leonardo KnijnikEmory University Adult Congenital Heart Center, Atlanta, Georgia.
Bo WangEmory University Adult Congenital Heart Center, Atlanta, Georgia.
Rhanderson CardosoHeart and Vascular Center, Brigham and Women's Hospital, Boston Massachusetts.
Colby ShanafeltEmory University Adult Congenital Heart Center, Atlanta, Georgia.
Michael S LloydEmory University Adult Congenital Heart Center, Atlanta, Georgia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Algorithms to automatically adjust atrioventricular (AV) and interventricular (VV) intervals in cardiac resynchronization therapy (CRT) devices are common, but their clinical efficacy is unknown. Objective: The purpose of this study was to evaluate automatic CRT algorithms in patients with heart failure for the reduction of mortality, heart failure hospitalizations, and clinical improvement. Methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) in patients with CRT using automatic algorithms that change AV and VV intervals dynamically without manual input, on a beat-to-beat basis. We performed a subgroup analysis including intracardiac electrogram-based (EGM) algorithms and contractility-based algorithms. Results: Nine RCTs with 8531 participants were included, of whom 4275 (50.1%) were randomized to automatic algorithm. Seven of the 9 trials used EGM-based algorithms, and 2 used contractility sensors. There was no difference in all-cause mortality (10.3% vs 11.3%; odds ratio [OR] 0.90; 95% confidence interval [CI] 0.71-1.03; Conclusion: Automatic algorithms that change AV or VV intervals did not improve mortality, heart failure hospitalizations, or cardiovascular symptoms in patients with heart failure and CRT.

Indexed as

AlgorithmCardiac resynchronization therapyHeart failureOptimizationPacing

Identifiers

PMID37936674
PMCPMC10626183

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Registered trials

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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.