Integrative and quantitive evaluation of the efficacy of his bundle related pacing in comparison with conventional right ventricular pacing: a meta-analysis.

BMC Cardiovasc Disord 2017 08 11;17(1):221. Epub 2017 Aug 11.

Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.

Background: Long-term RVP could bring adverse problems to cardiac electro-mechanics and result in inter- and intra-ventricular asynchrony, impaired labor force, and aggravation of cardiac function. HBRP including direct His bundle pacing and para-His bundle pacing was regarded as a novel physiological pacing pattern to avoid devastating cardiac function. This synthetic study was conducted to integratively and quantitatively evaluate the efficacy of His bundle related pacing (HBRP) in comparison with conventional right ventricular pacing (RVP).

Methods: Published studies on comparison of left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), New York Heart Association (NYHA) class, inter-ventricular asynchrony, and QRS duration, etc. between HBRP and RVP were collected and for meta-analysis.

Results: HBRP showed higher LVEF (WMD = 3.9%, 95% CI: 1.6% - 6.1%), lower NYHA class (WMD = -0.5, 95% CI: -0.7 - -0.3), WMD of LVESV = -0.1 ml, 95% CI: -3.0 - 2.8 ml), less inter-ventricular asynchrony (WMD = -13.2 ms, 95% CI: -16.4 - -10.0 ms), and shorter QRS duration for long-term (WMD = -36.9 ms, 95% CI: -40.0 - -33.8 ms), however, no significant difference of ventricular volume (WMDLVEDV = -2.4 ml, 95% CI: -5.0 - 0.2 ml; WMDLVESV = -0.1 ml, 95% CI: -3.0 - 2.8 ml) compared to RVP.

Conclusions: The efficacy of HBRP was firstly verified by meta-analysis to date. Compared with RVP, HBRP markedly preserve LVEF, NYHA class, and QRS duration. However, it seemed to have less effect on ventricular volume.

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12872-017-0649-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5553603PMC
August 2017

Publication Analysis

Top Keywords

bundle pacing
16
qrs duration
12
nyha class
12
left ventricular
12
ventricular pacing
8
conventional ventricular
8
ventricular volume
8
cardiac function
8
inter-ventricular asynchrony
8
comparison conventional
8
-30 28 ml
8
95% -30
8
efficacy bundle
8
pacing
7
95%
7
ventricular
7
hbrp
6
duration hbrp
4
rvp collected
4
hbrp rvp
4

Similar Publications