SynthesisFrontiers in physiology2025
Efficacy and safety of conduction system pacing in heart failure patients with non-left bundle branch block morphology: a systematic review and meta-analysis.
Synthesis in Frontiers in physiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
- Conduction system pacing as a rescue strategy for unsuccessful cardiac resynchronisation therapy implantation.Frontiers in physiology · 2026Article
- Pacemaker therapy through a sex-specific lens: a narrative review of clinical and procedural disparities.Frontiers in cardiovascular medicine · 2026Review
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Conduction system pacing, including His bundle pacing and left bundle branch area pacing, has emerged as a physiological alternative to biventricular pacing (BiVP) for cardiac resynchronisation therapy (CRT). BiVP benefits patients with left bundle branch block (LBBB), but outcomes in non-LBBB morphologies are inconsistent. We synthesised the evidence for CSP in heart failure patients with non-LBBB conduction patterns. Methods: We performed a systematic review and meta-analysis (PROSPERO CRD420251015905) of 21 studies (11 with quantitative data; n = 480). Comparative outcomes (CSP vs. BiVP) and baseline vs. follow-up CSP changes were pooled. Primary endpoints were left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), New York Heart Association (NYHA) class, and QRS duration. Secondary endpoints included heart failure hospitalisation and all-cause mortality. Results: In head-to-head analyses (198 patients; 99 per arm), CSP conferred a mean + 5.83% LVEF benefit (95% CI 3.06-8.60; Conclusion: In non-LBBB heart failure, CSP delivers substantial improvements in ventricular systolic function, reverse remodelling, symptoms, and electrical synchrony versus BiVP, with reduced HF hospitalisation. These findings position CSP as a promising BiVP strategy for a traditionally non-responder subgroup and warrant confirmation in large, randomised trials.
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