Why the study?
The feasibility and efficacy of His-Purkinje system pacing compared with biventricular pacing in cardiac resynchronization therapy were currently only evidenced by studies with limited sample sizes.
Does His-Purkinje system pacing improve clinical outcomes and cardiac function compared to biventricular pacing in patients with indication for cardiac resynchronization therapy?
Does His-Purkinje system pacing improve clinical outcomes and cardiac function compared to biventricular pacing in patients with indication for cardiac resynchronization therapy?
His-Purkinje system pacing may offer greater improvement in cardiac function compared to biventricular pacing for patients requiring cardiac resynchronization therapy.
May guide CRT pacing selection toward HPSP; extends meta-analytic support but requires larger RCTs for confirmation.
BACKGROUND: His-Purkinje system pacing (HPSP), including his-bundle pacing (HBP) and left bundle branch area pacing (LBBaP), imitates the natural conduction of the heart as an alternative to biventricular pacing (BVP) in cardiac resynchronization therapy (CRT). However, the feasibility and efficacy of HPSP were currently only evidenced by studies with a limited sample size, so this study aimed to provide a comprehensive assessment through a systematic review and meta-analysis. METHODS: In order to compare the clinical outcomes associated with HPSP and BVP in patients for CRT, PubMed, EMBASE, Cochrane Library and Web of Science database were searched from inception to April 10, 2023. Clinical outcomes of interest including QRS duration (QRSd), left ventricular (LV) function and New York Heart Association (NYHA) functional classification, pacing threshold, echocardiographic and clinical response, hospitalization rate of HF and all-cause mortality were also extracted and summarized for meta-analysis. CONCLUSION: The present findings suggested that HPSP was associated with greater improvement of cardiac function in patients with indication for CRT and was a potential alternative to BVP to achieve physiological pacing through native his-purkinje system.
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Wang et al. (2023) studied this question.
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