MP-453086-9 CARDIAC RESYNCHRONIZATION THERAPY IN HEART FAILURE WITH REDUCED EJECTION FRACTION: CONDUCTION SYSTEM PACING VERSUS BIVENTRICULAR PACING: A SYSTEMATIC REVIEW AND META-ANALYSIS

Conduction system pacing (CSP) is considered a more physiological form of in patients requiring cardiac resynchronization therapy (CRT). Recently there are studies showing the benefit CSP over biventricular (BVP) among with heart failure reduced ejection fraction (HFrEF). However, published data were based on small and mostly single-centered studies. To compare ECG, echocardiographic characteristics, clinical improvement HFrEF undergoing CRT versus BVP. This study protocol registered PROSPERO (CRD42022375155), review conducted per PRISMA protocol. Four major databases searched from inception till October 20, 2022, for relevant publications comparing conduction indications population. All extracted an excel spreadsheet. Data analysis was performed using RevMan 5.4 software. Dichotomous variables pooled odds ratio (OR) 95% confidence interval (CI). Continuous variable mean difference (MD). A total 10,072 references found database search. 35 assessed full days eligibility;18 (6 RCTs, 12 observational studies) 1375 included review. Following left bundle branch area (LBBAP), average paced QRS duration 28 ms narrower comparison to BVP (MD -27.69, CI -36.59 -18.80, n = 515), similar result obtained His (HBP) vs -31.76, -48.74 -14.77; n= 413). LVEF significantly improved [LBBAP 6.03, 4.16-7.91; 564); HBP 3.79, 0.46-7.11; 260); His-Purkinje (HPSP) 6.60, 4.42-8.78; n=477) (FIGURE). There higher being responders (OR 3.82, 1.88-7.75; 265)/super 2.08, 1.53-2.82; 811) (per ECHO findings) group, overall mortality 0.61, 0.40-0.93; 908) hospitalization (HHF) 0.37, 0.25-0.55; 993) lower group. Our showed that superior regard ECG parameters, as well outcomes terms HHF.