Aim Randomized controlled trials (RCTs) showed that biventricular (BiV) pacing reduces heart failure (HF) hospitalizations and mortality in patients with New York Heart Association (NYHA) class III-IV HF, left ventricular (LV) dysfunction, and wide QRS. We performed a systematic review and meta-analysis of the RCTs comparing LV-only vs. biventricular (BiV) pacing in candidates for cardiac resynchronization therapy (CRT). METHODS AND RESULTS: The systematic review selected five RCTs (out of 1888 analysed reports) with a cumulative number of 372 patients randomized to BiV pacing and 258 to LV-only pacing. The meta-analysis shows that BiV pacing is not superior to LV-only pacing and that these two pacing modalities do not differ with regard to death or heart transplantation [LV-only vs. BiV pacing odds ratio (OR) 1.24, 95% confidence interval (CI) 0.57-2.70 with the fixed effect model, OR 1.25, 95% CI 0.48-3.24 with the random effect model]. Specific data on hospitalizations were available only in two RCTs with a cumulative number of 127 patients randomized to BiV and 123 to LV-only pacing. The meta-analysis shows that BiV pacing is not superior to LV-only pacing and that these two pacing modalities do not differ with regard to this outcome (LV-only vs. BiV pacing OR 0.86, 95% CI 0.49-1.50 with the fixed effect model, OR 0.86, 95% CI 0.49-1.50 with the random effect model). CONCLUSIONS: Biventricular pacing is not superior to LV-only pacing, and these two pacing modalities appear to achieve similar efficacy in candidates for CRT for moderate to severe HF, in terms of all-cause mortality and hospitalizations during follow-up.

Meta-analysis of randomized controlled trials evaluating left ventricular vs. biventricular pacing in heart failure: effect on all-cause mortality and hospitalizations.

BORIANI, GIUSEPPE;GARDINI, BEATRICE;DIEMBERGER, IGOR;BACCHI REGGIANI, MARIA LETIZIA;BIFFI, MAURO;MARTIGNANI, CRISTIAN;ZIACCHI, MATTEO;VALZANIA, CINZIA;BRANZI, ANGELO
2012

Abstract

Aim Randomized controlled trials (RCTs) showed that biventricular (BiV) pacing reduces heart failure (HF) hospitalizations and mortality in patients with New York Heart Association (NYHA) class III-IV HF, left ventricular (LV) dysfunction, and wide QRS. We performed a systematic review and meta-analysis of the RCTs comparing LV-only vs. biventricular (BiV) pacing in candidates for cardiac resynchronization therapy (CRT). METHODS AND RESULTS: The systematic review selected five RCTs (out of 1888 analysed reports) with a cumulative number of 372 patients randomized to BiV pacing and 258 to LV-only pacing. The meta-analysis shows that BiV pacing is not superior to LV-only pacing and that these two pacing modalities do not differ with regard to death or heart transplantation [LV-only vs. BiV pacing odds ratio (OR) 1.24, 95% confidence interval (CI) 0.57-2.70 with the fixed effect model, OR 1.25, 95% CI 0.48-3.24 with the random effect model]. Specific data on hospitalizations were available only in two RCTs with a cumulative number of 127 patients randomized to BiV and 123 to LV-only pacing. The meta-analysis shows that BiV pacing is not superior to LV-only pacing and that these two pacing modalities do not differ with regard to this outcome (LV-only vs. BiV pacing OR 0.86, 95% CI 0.49-1.50 with the fixed effect model, OR 0.86, 95% CI 0.49-1.50 with the random effect model). CONCLUSIONS: Biventricular pacing is not superior to LV-only pacing, and these two pacing modalities appear to achieve similar efficacy in candidates for CRT for moderate to severe HF, in terms of all-cause mortality and hospitalizations during follow-up.
2012
Boriani G; Gardini B; Diemberger I; Bacchi Reggiani ML; Biffi M; Martignani C; Ziacchi M; Valzania C; Gasparini M; Padeletti L; Branzi A.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/117988
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