Evidence map›Paper›PMID 38668934›Full record

SynthesisJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2024

Improved all-cause mortality with left bundle branch area pacing compared to biventricular pacing in cardiac resynchronization therapy: a meta-analysis.

Juan Carlos Diaz, Mohamed Gabr, Usha B Tedrow, Mauricio Duque, Julian Aristizabal, Jorge Marin, Cesar Niño, Oriana Bastidas, Bruce A Koplan, Carolina Hoyos and 10 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Vectorcardiography in CRT: What We Know and What There Is to Learn.Journal of cardiovascular development and disease · 2025
    Review
  5. Review
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

20 authors.

Juan Carlos DiazCardiac Arrhythmia and Electrophysiology Service, Division of Cardiology, Clinica Las Vegas, Universidad CES Medical School, Medellin, Colombia.
Mohamed GabrCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Usha B TedrowCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Mauricio DuqueCardiac Arrhythmia and Electrophysiology Service, Division of Cardiology, Hospital San Vicente Fundacion, Rionegro, Colombia.
Julian AristizabalCardiac Arrhythmia and Electrophysiology Service, Division of Cardiology, Hospital San Vicente Fundacion, Rionegro, Colombia.
Jorge MarinCardiac Arrhythmia and Electrophysiology Service, Department of Medicine, Division of Cardiology, Clinica Las Americas, Medellin, Colombia.
Cesar NiñoCardiac Arrhythmia and Electrophysiology Service, Clinica SOMER, Rionegro, Colombia.
Oriana BastidasCardiac Arrhythmia and Electrophysiology Service, Hospital Pablo Tobon Uribe, Medellin, Colombia.
Bruce A KoplanCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Carolina HoyosCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Carlos D MatosCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Daniela HincapieCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Kevin Pacheco-BarriosNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Isabella AlvizCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Nathaniel A SteigerCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Sunil KapurCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Thomas M TadrosCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Paul C ZeiCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
William H SauerCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Jorge E RomeroCardiac Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. jeromero@bwh.harvard.edu.ORCID http://orcid.org/0000-0001-6420-8669

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLeft bundle branch area pacing (LBBAP) has emerged as a physiological alternative pacing strategy to biventricular pacing (BIVP) in cardiac resynchronization therapy (CRT). We aimed to assess the impact of LBBAP vs. BIVP on all-cause mortality and heart failure (HF)-related hospitalization in patients undergoing CRT.

methodsStudies comparing LBBAP and BIVP for CRT in patients with HF with reduced left ventricular ejection fraction (LVEF) were included. The coprimary outcomes were all-cause mortality and HF-related hospitalization. Secondary outcomes included procedural and fluoroscopy time, change in QRS duration, and change in LVEF.

resultsThirteen studies (12 observational and 1 RCT, n = 3239; LBBAP = 1338 and BIVP = 1901) with a mean follow-up duration of 25.8 months were included. Compared to BIVP, LBBAP was associated with a significant absolute risk reduction of 3.2% in all-cause mortality (9.3% vs 12.5%, RR 0.7, 95% CI 0.57-0.86, p < 0.001) and an 8.2% reduction in HF-related hospitalization (11.3% vs 19.5%, RR 0.6, 95% CI 0.5-0.71, p < 0.00001). LBBAP also resulted in reductions in procedural time (mean weighted difference- 23.2 min, 95% CI - 42.9 to - 3.6, p = 0.02) and fluoroscopy time (- 8.6 min, 95% CI - 12.5 to - 4.7, p < 0.001) as well as a significant reduction in QRS duration (mean weighted difference:- 25.3 ms, 95% CI - 30.9 to - 19.8, p < 0.00001) and a greater improvement in LVEF of 5.1% (95% CI 4.4-5.8, p < 0.001) compared to BIVP in the studies that reported these outcomes.

conclusionIn this meta-analysis, LBBAP was associated with a significant reduction in all-cause mortality as well as HF-related hospitalization when compared to BIVP. Additional data from large RCTs is warranted to corroborate these promising findings.

Indexed as

Cardiac Resynchronization TherapyCause of DeathHeart FailureBundle-Branch BlockHospitalizationHumansRisk AssessmentStroke VolumeSurvival RateTreatment OutcomeBiventricular pacingCardiac resynchronization therapyHeart failureLeft bundle branch area pacing

Identifiers

PMID38668934

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.