Key result
Conduction system pacing linked to increased LVEF and a ~3% rate of pacing-induced cardiomyopathy.
Why the study?
Most data on conduction system pacing evaluated only the impact on the left ventricle, leaving changes in morphology and function across all heart chambers incompletely assessed.
Does conduction system pacing improve echocardiographic parameters of morphology and function in patients with LVEF > 40% requiring pacing for bradyarrhythmia?
Population
128 consecutive patients with LVEF > 40% and successful CSP for bradyarrhythmic indication
Comparison
His bundle pacing vs left bundle branch area pacing
Design
Non-randomized prospective single-center study
Follow-up
Mean 699.2 ± 177.2 days
Authors
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Supports CSP to preserve LV function in paced patients with LVEF >40%; leaves open superiority versus RV pacing in RCTs.
Observational (n=128)
No
Does conduction system pacing improve echocardiographic parameters of morphology and function in patients with LVEF > 40% requiring pacing for bradyarrhythmia?
Absolute Event Rate: 56.7% vs 54.2%
p-value: p=0.01
Conduction system pacing is associated with preserved or improved biventricular function and a very low rate of pacing-induced cardiomyopathy in patients with baseline LVEF > 40%.
Pestrea et al. (2024) conducted an observational in Bradyarrhythmia with preserved and mid-range LVEF (n=128). Conduction system pacing (His bundle pacing or left bundle branch area pacing) vs. Baseline was evaluated on Left ventricular ejection fraction (LVEF) (p=0.01). Conduction system pacing significantly increased LVEF from 54.2% to 56.7% (p=0.01) and decreased LV volumes, with only 2.9% of patients developing pacing-induced cardiomyopathy.
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