Leadless left ventricular endocardial pacing for cardiac resynchronization therapy: A systematic review and meta-analysis.
Cardiac resynchronization therapy
Endocardial pacing
Heart failure
Leadless pacing
Meta-analysis
Systematic review
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
13
01
2022
revised:
01
02
2022
accepted:
14
02
2022
pubmed:
22
2
2022
medline:
8
7
2022
entrez:
21
2
2022
Statut:
ppublish
Résumé
Leadless left ventricular (LV) endocardial pacing to achieve cardiac resynchronization therapy (CRT) is a novel procedure for treatment of patients with dyssynchronous heart failure. Current evidence is limited to observational studies with small patient numbers. The purpose of this systematic review and meta-analysis was to assess the safety and efficacy of leadless LV endocardial pacing. A literature search was conducted through PubMed, EMBASE, and Cochrane databases. Mean differences (MDs) in New York Heart Association (NYHA) functional class and LV ejection fraction (LVEF) from baseline to 6 months postprocedure were combined using a random effects model. Heterogeneity was evaluated using the Cochrane Q test, I Five studies with 181 patients were included in the final analysis. Procedural success rate was 90.6%. Clinical response rate was 63%, with mean improvement in NYHA functional class of 0.43 (MD -0.43; 95% confidence interval [CI] -0.76 to -0.1; P = .01), with high heterogeneity (P <.001; I The efficacy of leadless LV endocardial pacing for CRT supports its use as a second-line therapy in patients in whom standard CRT is not possible or has been ineffective. Improvements in safety profile will facilitate widespread uptake in the treatment of these patients.
Sections du résumé
BACKGROUND
Leadless left ventricular (LV) endocardial pacing to achieve cardiac resynchronization therapy (CRT) is a novel procedure for treatment of patients with dyssynchronous heart failure. Current evidence is limited to observational studies with small patient numbers.
OBJECTIVE
The purpose of this systematic review and meta-analysis was to assess the safety and efficacy of leadless LV endocardial pacing.
METHODS
A literature search was conducted through PubMed, EMBASE, and Cochrane databases. Mean differences (MDs) in New York Heart Association (NYHA) functional class and LV ejection fraction (LVEF) from baseline to 6 months postprocedure were combined using a random effects model. Heterogeneity was evaluated using the Cochrane Q test, I
RESULTS
Five studies with 181 patients were included in the final analysis. Procedural success rate was 90.6%. Clinical response rate was 63%, with mean improvement in NYHA functional class of 0.43 (MD -0.43; 95% confidence interval [CI] -0.76 to -0.1; P = .01), with high heterogeneity (P <.001; I
CONCLUSION
The efficacy of leadless LV endocardial pacing for CRT supports its use as a second-line therapy in patients in whom standard CRT is not possible or has been ineffective. Improvements in safety profile will facilitate widespread uptake in the treatment of these patients.
Identifiants
pubmed: 35189383
pii: S1547-5271(22)00199-0
doi: 10.1016/j.hrthm.2022.02.018
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1176-1183Subventions
Organisme : Wellcome Trust
ID : WT203148/Z/16/Z
Pays : United Kingdom
Organisme : NHLBI NIH HHS
ID : R01 HL152256
Pays : United States
Informations de copyright
Copyright © 2022 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.