Key result
Conduction system pacing is reviewed as an emerging alternative to biventricular pacing for heart failure patients with wide QRS duration, highlighting current gaps in evidence.
Why the study?
Conduction system pacing has been proposed to replace biventricular pacing due to shortcomings like coronary sinus lead failure and unsatisfactory response, prompting a review of the evidence and existing gaps.
Does conduction system pacing improve outcomes compared to biventricular pacing in patients with heart failure and wide QRS duration?
Does conduction system pacing improve outcomes compared to biventricular pacing in patients with heart failure and wide QRS duration?
This review discusses the current evidence and gaps regarding the potential for conduction system pacing to replace biventricular pacing in heart failure patients with wide QRS duration.
Answers are grounded in this paper and cite their sources.
Current evidence gaps preclude replacing biventricular pacing with conduction system pacing in heart failure; leaves open whether randomized trials will establish superiority.
Conduction system pacing CSP) is an emerging therapy for resynchronization of patients with heart failure and wide QRS duration. It has been proposed to replace cardiac resynchronization therapy with biventricular pacing (CRT with BVP) mainly because of shortcoming of CRT with BVP including failure to implant coronary sinus leads and unsatisfactory response in certain subset of heart failure patients. The current evidence for CSP in heart failure patients with wide QRS duration is reviewed and the gap in evidence in supporting CSP to replace CRT with BVP is discussed.
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A 2025 study conducted a review in Heart failure with wide QRS duration. Conduction system pacing vs. Biventricular pacing was evaluated. Conduction system pacing is reviewed as an emerging alternative to biventricular pacing for heart failure patients with wide QRS duration, highlighting current gaps in evidence.
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