Trial reportEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025
Biventricular vs. right ventricular pacing devices in patients anticipated to require frequent ventricular pacing (BioPace).
Trial report in 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT00187278 (Biventricular Pacing for Atrioventricular Block in Left Ventricular Dysfunction to Prevent Cardiac Desynchronization), which is not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Biventricular Pacing for Atrioventricular Block in Left Ventricular Dysfunction to Prevent Cardiac Desynchronization
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative effects of biventricular and right ventricular pacing on clinical outcomes in atrioventricular block: a systematic review and meta-analysis.BMC cardiovascular disorders · 2025Pooled it
- Cardiac implantable electronic devices in heart failure: needs, challenges, and real-world implementation.Heart failure reviews · 2026Review
- Conduction system pacing: what emerging evidence and what indications?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 · 2026Review
- Permanent LEft ventricular septAl Pacing vs. right ventricular pacing in patients with atrioventricular conduction disorders-a randomized trial: rationale and design of the LEAP trial.European heart journal open · 2026Article
- Cardiac Resynchronization Therapy: A Review.JAMA · 2026Review
- Predictors of pacing-induced cardiomyopathy in patients undergoing AV nodal ablation: insights from a Delphi process and retrospective cohort study.European heart journal open · 2026Article
- Left bundle branch area pacing vs right ventricular pacing for atrioventricular block: the MELOS RELOADED study.European heart journal · 2026Article
- Screening for HFpEF in pacemaker patients: Study design and protocol of the PM-HFpEF study.PloS one · 2026Article
- [Comment on the European Society of Cardiology (ESC) Clinical Consensus Statement on the indication for conduction system pacing].Herzschrittmachertherapie & Elektrophysiologie · 2025Review
- Long-term outcomes of upgrading to cardiac resynchronization therapy in patients with left bundle branch block or right ventricular pacing.Heart rhythm O2 · 2025Article
- Article
- Physiological pacing: mechanisms, clinical indications, and perspectives.European heart journal · 2025Review
- How harmful is right ventricular pacing? The question revived by the BioPace trial.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 · 2025Article
- Comparing the effects of left bundle branch pacing and leadless right ventricular pacing on intraventricular and interventricular dyssynchrony usingFrontiers in physiology · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
11 authors.
Funding
Abstract
aimsRight ventricular (RV) pacing may promote left ventricular (LV) dysfunction. Particularly in patients with preserved LV ejection fraction (LVEF), narrow QRS, and anticipated high ventricular pacing burden (HVPB), evidence is missing that biventricular (BiV) pacing can improve clinical outcome. We therefore evaluated whether implantation of a BiV pacing device (BiVPD) compared with a RV pacing device (RVPD) may improve clinical outcome in predominantly this kind of patients. METHODS AND
resultsIn the Biventricular Pacing for atrioventricular Block to Prevent Cardiac Desynchronization (BioPace) trial [multicentre, single-blinded (patients), randomized, parallel group], patients were equally allocated to either receive a BiVPD or a RVPD. Co-primary endpoints were (i) the composite of time to death or first heart failure hospitalization and (ii) survival time. We analysed 1810 randomized patients (median age: 73.5 years; female sex: 31.7%; mean LVEF 55.4%; mean QRS 118.4 ms), 902 to BiV and 908 to RV pacing. During mean follow-up of 68.8 months, the difference in the primary composite endpoint between both groups [346 vs. 363 events, hazard ratio (HR) 0.878; 95% confidence interval (CI) 0.756-1.020; P = 0.0882) or in mortality (305 vs. 307 deaths, HR 0.926; 95% CI 0.789-1.088; P = 0.3492) was smaller than 20%.
conclusionIn patients, predominantly with preserved LVEF, narrow QRS, and HVPB, superiority of implanting BiVPDs compared with RVPDs could not be proven. Right ventricular pacing may be less harmful for this kind of patients than often suggested and primary BiV pacing does not clearly improve their clinical outcome. CLINICAL
trial registrationRegistered in ClinicalTrials.gov, number NCT00187278 (https://clinicaltrials.gov/ct2/show/study/NCT00187278).
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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.