Related Experiment Video

Updated: Aug 14, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Conduction system vs. biventricular pacing in heart failure with reduced ejection fraction: a meta-analysis of

Paschalis Karakasis1, Konstantinos Vlachos2,3,4, Konstantinos C Siontis5

  • 1Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|August 12, 2026
PubMed

Insights

Conduction system pacing (CSP) offers a safer alternative to biventricular pacing (BiVP) for heart failure with reduced ejection fraction patients. CSP reduces hospitalizations and mortality, improving functional capacity without compromising safety.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Conduction system pacing (CSP) is a novel approach for heart failure with reduced ejection fraction (HFrEF) patients.
  • Its efficacy compared to traditional biventricular pacing (BiVP) for cardiac resynchronization therapy (CRT) requires further clarification.

Purpose of the Study:

  • To compare the clinical outcomes of CSP versus BiVP in HFrEF patients undergoing CRT.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
  • Data from 13 RCTs involving 1320 participants (657 CSP, 663 BiVP) were synthesized.

Main Results:

  • CSP was linked to a reduced composite risk of heart failure hospitalization or all-cause mortality (OR 0.51).
  • CSP demonstrated significant improvements in 6-minute walk distance and NYHA functional class.
  • No significant differences were found in hospitalization for heart failure alone, all-cause mortality, or safety outcomes.

Conclusions:

  • CSP presents a favorable alternative to BiVP for CRT in HFrEF patients.
  • CSP improves functional capacity and reduces the composite risk of adverse events, with comparable safety and procedural results.
Abstract

Keywords:
Biventricular pacingCardiac resynchronization therapyConduction system pacingHeart failure with reduced ejection fractionHospitalization for heart failureLeft bundle branch area pacingMortality

More Related Videos

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...