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Clinical outcome of left ventricular multipoint pacing versus conventional biventricular pacing in cardiac resynchronization therapy: a systematic review and meta-analysis

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Abstract

Cardiac resynchronization therapy (CRT) is an effective treatment for selected patients with systolic heart failure. Unlike conventional biventricular pacing (BIP), the left ventricular multipoint pacing (MPP) can increase the number of left ventricular pacing sites via a quadripolar lead positioned in the coronary sinus. This synthetic study was conducted to integratively and quantitatively evaluate the clinical outcome of MPP in comparison with BIP. We systematically searched the databases of EMBASE, Ovid medline, and Cochrane Library through May 2018 for studies comparing the clinical outcome of MPP with BIP in the patients who accepted CRT. Hospitalization for reason of heart failure, left ventricular eject fraction (LVEF), CRT response, all-cause morbidity, and cardiovascular death rate was collected for meta-analysis. A total of 11 studies with 29,606 participants were included in this meta-analysis. Compared with BIP group, MPP decreased heart failure hospitalization (OR, 0.41; 95% CI, 0.33 to 0.50; P < 0.00001), improved LVEF (mean difference, 4.97; 95% CI, 3.11 to 6.83; P < 0.00001), increased CRT response (OR, 3.64; 95% CI, 1.68 to 7.87; P = 0.001), and decreased all-cause morbidity (OR, 0.41; 95% CI, 0.26–0.66; P = 0.0002) and cardiovascular death rate (OR, 0.21; 95% CI, 0.11–0.40; P < 0.00001). The published literature demonstrates that MPP was more effective than BIP in the heart failure patients who accepted cardiac resynchronization therapy.

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Funding

This work was supported by the National Key R&D Program of China (2017YFC1307800).

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Authors and Affiliations

  1. State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Feng Hu, Lihui Zheng, Ligang Ding, Zhongpeng Du, Erpeng Liang, Lingmin Wu, Gang Chen, Xiaohan Fan & Yan Yao

  2. School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, DongDan SanTiao 9, DongCheng District, Beijing, People’s Republic of China

    Yu Jiang

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  1. Feng Hu
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Hu, F., Zheng, L., Ding, L. et al. Clinical outcome of left ventricular multipoint pacing versus conventional biventricular pacing in cardiac resynchronization therapy: a systematic review and meta-analysis. Heart Fail Rev 23, 927–934 (2018). https://doi.org/10.1007/s10741-018-9737-5

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  • DOI: https://doi.org/10.1007/s10741-018-9737-5

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