ArticleInternational journal of cardiology. Heart & vasculature2026
Empiric pacing in unexplained syncope and bifascicular block: A systematic review and meta-analysis.
Article in International journal of cardiology. Heart & vasculature, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Patients with unexplained syncope and bifascicular block (BFB) are at risk for intermittent high-grade atrioventricular block. Management strategies include empiric pacemaker implantation (EPI) or other alternative approaches (implantable cardiac monitor or electrophysiology study), but the optimal strategy remains uncertain. Objective: To evaluate the efficacy and safety of EPI compared to alternative approaches in patients with unexplained syncope and BFB. Methods: We systematically reviewed six studies (2 randomized controlled trials and 4 cohort studies; n = 601) comparing EPI versus alternative strategies in patients with BFB and unexplained syncope. Primary outcomes were predefined as syncope and bradycardia. Secondary outcomes were bradyarrhythmia, cardiovascular death, and device complications. Risk ratios (RR) were synthesized with a random-effects model. Results: EPI significantly reduced recurrence of syncope (RR 0.48 [0.35, 0.65], p = 3.4E-6), bradycardia (RR 0.06 [0.016, 0.26], p = 7.6E-5), and bradyarrhythmia (RR 0.64 [0.43, 0.96], p = 0.034). Notably, neither device-related complications (RR 1.30 [1.00-1.71], p = 0.06) nor cardiovascular death (RR 0.98 [0.82-1.16], p = 0.82) were significantly increased with EPI. Conclusion: In patients with unexplained syncope and BFB, EPI significantly reduces recurrent syncope and bradycardia without increasing device-related complications or cardiovascular mortality. These findings support the efficacy and safety of empiric pacing as a reasonable management strategy in this high-risk population.
Indexed as
Identifiers
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.