{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:20:36Z","timestamp":1791354036764,"version":"4.3.1"},"reference-count":51,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Conduction system pacing (CSP) is observed to produce greater improvements in echocardiographic and hemodynamic parameters as compared to conventional biventricular pacing (BiVP). However, whether these surrogate endpoints directly translate to improvements in hard clinical outcomes such as death and heart failure hospitalization (HFH) with CSP remains uncertain as studies reporting these outcomes are scarce. The aim of this meta\u2010analysis was to analyze the existing data to compare the clinical outcomes of CSP versus BiVP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search of the Embase and PubMed database was performed for studies comparing CSP and BiVP for patients indicated to receive a CRT device. The coprimary endpoints were all\u2010cause mortality and HFH. Other secondary outcomes included change in left ventricular ejection fraction (LVEF), change in NYHA class, and increase in NYHA class \u22651. A random\u2010effects model was chosen a priori to analyze the composite effects given the anticipated heterogeneity of included trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010one studies (4 randomized and 17 observational) were identified reporting either primary outcome and were included in the meta\u2010analysis. In total 1960 patients were assigned to CSP and 2367 to BiVP. Median follow\u2010up time was 10.1 months (ranging 2\u201333 months). CSP was associated with a significant reduction in all\u2010cause mortality (odds ratio [OR] 0.68, 95% confidence interval [CI]: 0.56\u20130.83) and HFH (OR 0.52, 95% CI: 0.44\u20130.63). Mean improvement in LVEF was also greater with CSP (mean difference 4.26, 95% CI: 3.19\u20135.33). Reduction in NYHA class was significantly greater with CSP (mean difference \u22120.36, 95% CI: \u22120.49 to \u22120.22) and the number of patients with an increase in NYHA class \u22651 was significantly greater with CSP (OR 2.02, 95% CI: 1.70\u20132.40).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CSP was associated with a significant reduction in all\u2010cause mortality and HFH when compared to conventional BiVP for CRT. Further large\u2010scale randomized trials are needed to verify these observations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15976","type":"journal-article","created":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T09:00:51Z","timestamp":1687424451000},"page":"1718-1729","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Clinical outcomes of conduction system pacing versus biventricular pacing for cardiac resynchronization therapy: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8719-146X","authenticated-orcid":false,"given":"Jitae A.","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seulgi E.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal 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