{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:46:46Z","timestamp":1782780406749,"version":"3.54.5"},"reference-count":62,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Right ventricular pacing (RVP) is the conventional treatment for atrioventricular (AV) block, but may cause ventricular dyssynchrony and adverse remodeling. Conduction system pacing (CSP) has emerged as a physiologic alternative. This meta-analysis compared the efficacy, safety, echocardiographic, and electrical outcomes of CSP versus RVP in patients with AV block.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From 2,688 records identified in PubMed, Cochrane, Embase, and ScienceDirect, 19 studies were included. Pooled efficacy, safety, echocardiographic, and procedural outcomes were analyzed using a random-effects model in R (v4.5.1), with meta-regression assessing follow-up effects;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 was considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nineteen studies comprising 5,390 patients (2,182 CSP; 3,208 RVP) were analyzed. Compared with RVP, CSP was associated with a reduction in all-cause mortality (RR 0.50, p &lt; 0.0001), heart failure hospitalization (RR 0.39, p &lt; 0.0001), pacing-induced cardiomyopathy (RR 0.36, p = 0.039), and the primary composite outcome (RR 0.44, p &lt; 0.0001). Cardiovascular death, cardiac resynchronization therapy upgrade, and biventricular pacing upgrade did not differ significantly between groups. CSP was associated with improved left ventricular ejection fraction (MD +2.60%, p &lt; 0.0001) and reduced left ventricular end-diastolic diameter (MD \u22121.54 mm, p &lt; 0.0001) compared with RVP. Shorter paced QRS duration at implantation and follow-up was observed with CSP compared with RVP, indicating superior ventricular synchrony, although procedural and fluoroscopy times were longer. Meta-regression indicated that LVEF improvement decreased with longer follow-up, while LVEDD reduction remained consistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CSP was associated with lower all-cause mortality, HF hospitalization, and pacing-induced cardiomyopathy, while improving ventricular function without additional device-related complications compared with RVP; however, these findings should be interpreted in the context of predominantly observational data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-026-05930-6","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T11:54:33Z","timestamp":1778068473000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and electrical outcomes of conduction system pacing versus right ventricular pacing in atrioventricular block: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Faizan","family":"Ahmed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Zulfiqar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramsha","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafsa Arshad Azam","family":"Raja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omama","family":"Ayatullah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Kamel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsalan","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7057-9975","authenticated-orcid":false,"given":"Haris Bin","family":"Tahir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faseeh","family":"Haider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Faiq","family":"Akram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam Abbas","family":"Malik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rubiya","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana","family":"Altaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haider Hussain","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeeha","family":"Shafqat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Aziz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawaz","family":"Alenezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran S.","family":"Zacks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"5930_CR1","unstructured":"Ahmed I, Goyal A, Chhabra L. 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