Left bundle branch area pacing in mildly reduced heart failure: A systematic literature review and meta‐analysis

Cardiac resynchronization therapy (CRT) strategy for heart failure with mildly reduced ejection fraction (HFmrEF) is controversial. Left bundle branch area pacing (LBBAP) is an emerging pacing modality and an alternative option to CRT. This analysis aimed to perform a systematic review of the litera...

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Published in:Clinical cardiology (Mahwah, N.J.) N.J.), 2023-07, Vol.46 (7), p.713-720
Main Authors: Yu, Ga‐In, Kim, Tae‐Hoon, Cho, Yun‐Ho, Bae, Jae‐Seok, Ahn, Jong‐Hwa, Jang, Jeong Yoon, Park, Yong Whi, Kwak, Choong Hwan
Format: Article
Language:English
Subjects:
Cardiac Pacing, Artificial - methods
cardiac resynchronization therapy
Cardiac Resynchronization Therapy - adverse effects
Cardiac Resynchronization Therapy - methods
Case reports
Editorials
Ejection fraction
Electrocardiography - methods
Heart Conduction System
Heart failure
Heart Failure - diagnosis
Heart Failure - therapy
heart failure with mildly reduced ejection fraction
Humans
left bundle branch area pacing
left ventricular ejection fraction
Literature reviews
Meta-analysis
Morphology
QRS duration
Review
Reviews
Standard deviation
Stroke Volume
Transplants & implants
Treatment Outcome
Ventricular Function, Left
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Summary:Cardiac resynchronization therapy (CRT) strategy for heart failure with mildly reduced ejection fraction (HFmrEF) is controversial. Left bundle branch area pacing (LBBAP) is an emerging pacing modality and an alternative option to CRT. This analysis aimed to perform a systematic review of the literature and meta‐analysis on the impact of the LBBAP strategy in HFmrEF, with left ventricular ejection fraction (LVEF) between 35% and 50%. PubMed, Embase, and Cochrane Library were searched for full‐text articles on LBBAP from inception to July 17, 2022. The outcomes of interest were QRS duration and LVEF at baseline and follow‐up in mid‐range heart failure. Data were extracted and summarized. A random‐effect model incorporating the potential heterogeneity was used to synthesize the results. Out of 1065 articles, 8 met the inclusion criteria for 211 mid‐range heart failure patients with an implant LBBAP across the 16 centers. The average implant success rate with lumenless pacing lead use was 91.3%, and 19 complications were reported among all 211 enrolled patients. During the average follow‐up of 9.1 months, the average LVEF was 39.8% at baseline and 50.5% at follow‐up (MD: 10.90%, 95% CI: 6.56−15.23, p 
ISSN:0160-9289
1932-8737
1932-8737
DOI:10.1002/clc.24028