Comparison of his bundle pacing versus biventricular pacing in heart failure: a systematic review and meta-analysis

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Despite optimal medical treatment, the 5-years mortality and HF readmission rate was 75.3% 48.5%, respectively. The current guidelines recommended cardiac resynchronization therapy (CRT) by implanting biventricular pacing (BVP) for specific group patients with reduced ejection fraction (HFrEF) in order to reduce risk events 34%. However, 20% 40% might not respond or even get clinical deterioration after receiving such device. To overcome non-responders, His bundle (HBP) emerges recently as one therapeutic options. implantation potentially results narrower QRS duration well more improvement left ventricle (LV) function compared BVP LBBB. On top that, HBP become a cost-effective solution, CRT, particularly majority developing countries Asia. Purpose We aim elaborate efficacy HF, BVP. This implanted either primary strategy CRT candidates rescue non-responders. Methods study is registered. A structured search conducted Pubmed, Embase, Clinicaltrial.gov. Inclusion criteria were: Age >18 years old, NYHA II-IV, ≥120 milliseconds, (LBBB) right branch block (RBBB) morphology. endpoints were change duration, LVEF, class, cardiovascular (CV) event. Results total 8 final articles involving 361 included analysis, male preponderance. significantly (MD: -23.44; 95%CI -34.92 -11.97; P<0.001) There no statistically significant LVEF between who 4.63; -4.47 13.74; P=0.32). class varied studies. One reported comparable BVP, while another better In terms CV outcome, there difference hospitalization rate. Heart failure occurred both group, but groups. Improvement LBBB RBBB. Conclusion(s) provides electrical Additionally, some degree reverse LV remodelling also observed RBBB patterns. benefits reducing remain indeterminate. Further RCTs large samples are still required evaluate superiority HBP, hospitalization.