Why the study?
BiVP is standard CRT for symptomatic HFrEF with electrical dyssynchrony despite GDMT, but has limitations including technical difficulties and high non-response rates.
Does conduction system pacing improve outcomes compared to biventricular pacing in symptomatic heart failure patients with reduced ejection fraction and electrical dyssynchrony?
Does conduction system pacing improve outcomes compared to biventricular pacing in symptomatic heart failure patients with reduced ejection fraction and electrical dyssynchrony?
This review summarizes current evidence, guidelines, and ongoing trials comparing conduction system pacing to biventricular pacing for cardiac resynchronization in HFrEF.
Evidence insufficient to prefer conduction system over biventricular pacing in HFrEF; ongoing trials may resolve comparative efficacy.
Biventricular pacing (BiVP) has been the cornerstone of cardiac resynchronization therapy (CRT) in the management of symptomatic heart failure patients with reduced ejection fraction (HFrEF) and electrical dyssynchrony despite guideline-directed medical therapy (GDMT). However, BiVP has some limitations, including technical difficulties and high non-response rates. Conduction system pacing encompassing His bundle pacing (HBP) and left bundle branch area pacing (LBBAP) has recently emerged as a promising alternative to CRT in this group of patients. In this review, we explore the current evidence, guidelines, limitations, gaps in knowledge, and ongoing trials comparing CSP and BiVP for the management of HFrEF with electrical dyssynchrony.
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Ammar et al. (2024) studied this question.
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