ReviewJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2025
Left bundle branch area pacing prevails over His bundle pacing for heart failure patients undergoing atrioventricular node ablation in permanent atrial fibrillation: a network meta-analysis.
Review in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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Who cites it
2 citing papers in PubMed.
- Left Bundle Branch Area Pacing in Cardiac Resynchronization Therapy: How Does It Compare to Biventricular Pacing in Terms of Electrocardiographic Parameters and Procedural Outcomes?Journal of clinical medicine · 2025Article
- Determining Good Candidates for Atrioventricular Junction Ablation and Device Therapy and Which Device to Implant.Arrhythmia & electrophysiology review · 2025Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundAtrioventricular node ablation (AVNA) and pacemaker implantation enhance prognosis in heart failure patients experiencing rapid ventricular response due to atrial fibrillation. This meta-analysis assessed the clinical benefits of various pacing modalities following AVNA.
methodsThe electrophysiological endpoint was defined as QRS duration, while the echocardiographic endpoint was the change in left ventricular ejection fraction. Secondary endpoints included pacing threshold, mortality rates, and improvements in the 6-min walk test.
resultsThis meta-analysis of 13 studies involving 1257 patients suggested that His bundle pacing (HBP) and left bundle branch area pacing (LBBAP) conferred an advantage in narrowing QRS duration compared to biventricular pacing (BVP) (HBP vs BVP OR = - 59.05, 95%CI = - 73.12 to - 44.97; LBBAP vs BVP OR = - 48.64, 95%CI = - 64.05 to - 33.24). The findings of echocardiographic endpoints suggested that LBBAP and HBP emerged as the optimal strategies over RVP (vs HBP OR = - 7.59, 95%CI = - 11.85 to - 3.32; vs LBBAP OR = - 6.58, 95%CI = - 12.08 to - 1.07). LBBAP reduced all-cause mortality compared to BVP (OR = 0.10, 95%CI = 0.01-0.78); however, no significant differences in all-cause mortality were observed between LBBAP and HBP. The pacing threshold of LBBAP was significantly lower than HBP (OR = - 0.40, 95%CI = - 0.57 to - 0.23).
conclusionLBBAP not only demonstrated superior clinical outcomes regarding mortality compared to ventricular pacing strategies, but also was associated with a lower pacing threshold than HBP, thereby indicating its potential advantage over HBP in patients undergoing AVNA and subsequent pacemaker implantation.
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