Evidence map›Paper›PMID 39775893›Full record

SynthesisJournal of cardiovascular electrophysiology2025

Left Bundle Branch Area Pacing Versus Right Ventricular Pacing in Patients With Atrioventricular Block: A Systematic Review and Meta-Analysis.

Irfan Ahsan, Hussam Al Hennawi, Angad Bedi, Muhammad Khuzzaim Khan, Nikhil Duseja, Reginald T Ho

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 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, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Right ventricular function after left bundle branch area pacing versus right ventricular pacing: a prospective evaluation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  3. Can we rely on remote electrogram analysis to monitor long-term conduction system capture in left bundle branch area pacing?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 · 2026
    Article
  4. Article
  5. 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

6 authors.

Irfan AhsanDivision of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Hussam Al HennawiDepartment of Internal Medicine, Jefferson Abington Hospital, Abington, Pennsylvania, USA.ORCID 0000-0002-1968-4962
Angad BediDepartment of Internal Medicine, Jefferson Abington Hospital, Abington, Pennsylvania, USA.
Muhammad Khuzzaim KhanDepartment of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Nikhil DusejaDepartment of Internal Medicine, Karachi Medical and Dental College, Karachi, Pakistan.ORCID 0009-0003-1186-7443
Reginald T HoDivision of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-9198-5025

Funding

The authors received no specific funding for this work.
6 · The paper itself

Abstract

backgroundLeft bundle branch area pacing (LBBAP) is a new technique for patients with atrioventricular block (AVB) and preserved left ventricular ejection fraction (LVEF), potentially offering better cardiac function than right ventricular pacing (RVP).

methodsWe searched databases and registries for studies that compared LBBAP with RVP in patients with AVB and preserved LVEF. We extracted data on various outcomes and pooled the effect estimates using random-effects models.

resultsOur meta-analysis included 14 studies (10 observational and 4 RCTs) involving 3062 patients with AVB. The analysis revealed that the QRS duration was significantly shorter in the LBBAP group compared to the RVP group [MD = -35.56 ms; 95% CI: (-39.27, -31.85), p < 0.00001]. Patients in the LBBAP group also exhibited a significant increase in left ventricular ejection fraction (LVEF) [MD = 5.48%; 95% CI: (4.07%, 6.89%), p < 0.00001], and a significant reduction in left ventricular end-diastolic diameter (LVEDD) compared to RVP [MD = -3.98 mm; 95% CI: (-5.88, -2.09 mm), p < 0.0001]. In terms of clinical outcomes, LBBAP was associated with a significantly lower risk of heart failure hospitalizations (HFHs) compared to RVP [OR = 0.26; 95% CI: (0.16, 0.44), p < 0.0001]. However, no significant differences were observed between the two groups in the implant success rate, pacing impedance, or pacing threshold. The RVP group demonstrated a significantly higher R-wave amplitude increase than the LBBAP group [MD = 0.85 mV; 95% CI: (0.23, 1.46), p = .007]. Lastly, there was no significant difference in the incidence of complications between the two groups [OR = 2.12; 95% CI: (0.29, 15.52), p = 0.46].

conclusionLBBAP outperforms RVP in several cardiac function indicators, suggesting it may be a superior pacing method for AVB patients with preserved LVEF. However, the small sample size in studies and the result in heterogeneity call for more research to validate these findings and assess LBBAP's long-term effects.

Indexed as

Atrioventricular BlockBundle of HisCardiac Pacing, ArtificialVentricular Function, LeftVentricular Function, RightAction PotentialsAgedFemaleHeart RateHumansMaleMiddle AgedRecovery of FunctionRisk FactorsStroke VolumeTime Factorscardiac resynchronization therapyleft bundle branch pacingright ventricular pacing

Identifiers

PMID39775893
PMCPMC11837886

What OpenQuestion holds

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LicenceCC BY-NC
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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.