ArticleFrontiers in physiology2026
Conduction system pacing as a rescue strategy for unsuccessful cardiac resynchronisation therapy implantation.
Article in Frontiers in physiology, 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: Failure to achieve effective cardiac resynchronisation therapy (CRT) remains a clinically significant challenge, often driven by anatomical constraints or suboptimal left ventricular lead performance. Conduction system pacing (CSP), incorporating His bundle pacing and left bundle branch area pacing, has emerged as a physiological alternative; however, data focussing specifically on its role as a rescue strategy following unsuccessful CRT implantation, rather than biological non-response, remain limited. Objective: To evaluate the feasibility, safety, and short- to mid-term clinical and echocardiographic outcomes of CSP in patients with unsuccessful conventional CRT implantation. Methods: In this single-centre retrospective study, consecutive patients undergoing attempted CSP after unsuccessful CRT between January 2020 and May 2025 were analysed. Unsuccessful CRT was defined as inability to deliver effective biventricular pacing due to anatomical or technical limitations, excluding patients with true non-response despite successful implantation. Procedural success, electrical resynchronisation, changes in left ventricular ejection fraction (LVEF), and clinical outcomes were assessed. Results: Thirty-two patients (mean age 69 years, mean LVEF 27.8%) were included. CSP was successfully achieved in 91% of cases, predominantly using left bundle branch area pacing. Baseline QRS duration (165 ± 38 ms) significantly narrowed to 122 ± 19.8 ms following CSP. This was accompanied by marked improvement in LVEF (from 27.0 ± 8.6% to 47.7 ± 11.2%, p < 0.001). Procedural complications were infrequent, with one pneumothorax and no device-related infections. Over a mean follow-up of 641 ± 522 days, heart failure hospitalisation occurred in 7%, and three deaths were observed, non-attributable to device-related causes. Conclusion: CSP is a highly feasible and safe rescue strategy in patients with unsuccessful CRT implantation, achieving substantial electrical resynchronisation and meaningful recovery of left ventricular function. These findings support CSP as a compelling alternative in anatomically or technically challenging CRT cases where conventional resynchronisation delivery is not achievable.
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.