ReviewEuropace : 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
Controversy: in heart failure patients with a reduced ejection fraction and left bundle branch block, conduction system pacing can be a valid alternative to biventricular pacing-pro and contra.
Review 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. It is linked to trial NCT07604727 (AV Nodal Ablation With Conduction System Pacing Versus Cardiac Resynchronization for Symptomatic Heart Failure Patients With Atrial Fibrillation), which is not on this map. Cited by 10 papers, 3 of them syntheses that pooled 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.
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.
AV Nodal Ablation With Conduction System Pacing Versus Cardiac Resynchronization for Symptomatic Heart Failure Patients With Atrial Fibrillation: The APAF-CSP All-cause Mortality and Quality of Life Trial
Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Conduction system pacing vs. biventricular pacing for cardiac resynchronization therapy in heart failure: a systematic review and meta-analysis considering randomized controlled trials and observational studies.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 · 2026Pooled it
- Conduction system vs. biventricular pacing in heart failure with reduced ejection fraction: a meta-analysis of randomized controlled trials.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 · 2026Pooled it
- Conduction system pacing for cardiac resynchronization therapy: a systematic review.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 · 2026Pooled it
- Decoding the evidence emerging from the studies comparing conduction system pacing with conventional cardiac resynchronization therapy.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 · 2026Article
- 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
- Lead replacement due to non-infectious reasons in patients with cardiac resynchronization therapy in long-term follow-up.ESC heart failure · 2026Article
- Characteristics of paced waveforms and current of injury prior to septal perforation during 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 · 2026Article
- Synergistic Value of Combined Electrical, Structural, and Functional Response Metrics in the Prediction of Long-Term Event-Free Survival After Cardiac Resynchronization Therapy.Reviews in cardiovascular medicine · 2026Article
- Atrial resynchronization: an overlooked concept in heart failure and conduction system pacing: review of selected literature with emphasis on atrial anatomy.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
- Contemporary insights and evolving clinical pathways in transcatheter tricuspid valve replacement.Herz · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
For patients with heart failure (HF) and bundle branch block, cardiac resynchronization therapy (CRT) by biventricular pacing (BiVP) has been found effective and has been widely used for around 20 years. The effects of BiVP are well documented in a row of large randomized controlled trials (RCTs) with long-term follow-up to include prolonged survival, less HF hospitalizations, and better quality of life for the patients. More recently, conduction system pacing (CSP) as His bundle pacing or left bundle branch area pacing has been introduced for CRT and shown to in best cases establish a normal or near-to-normal electrical activation of the left ventricular myocardium. Data from large RCTs documenting the beneficial effects of CSP are awaited. Currently, the question is to what extent the contemporary literature supports a transition from BiVP to CSP for CRT in patients with HF and bundle branch block. This Europace Controversy article presents opposing viewpoints on this topic. H.B., M.J., and J.J. argue in favour of CSP being superior to BiVP. Conversely, C.L., N.B., and J.C.D. advocate for BiVP still being the first choice for CRT. This Controversy aims to present data and their interpretation from different expert perspectives on an important topic in CRT for HF.
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What OpenQuestion holds
Registered trials
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.