This systematic review and meta-analysis looked at data from 7,019 adult patients with heart failure and a reduced pumping function. The researchers compared conduction system pacing with biventricular pacing to see which approach worked better.
The analysis found that conduction system pacing led to greater improvements in heart pumping strength and symptoms. Patients also experienced shorter electrical signals in the heart and a lower risk of needing hospitalization for heart failure. The procedure also took less time during the initial setup.
However, the risk of death from any cause was similar for both groups. The researchers noted that the overall certainty of this evidence is low to very low. They also detected some publication bias in the data regarding heart pumping strength. Because of these limitations, the findings should be viewed as hypothesis-generating. Large-scale clinical trials are urgently needed to confirm these benefits before conduction system pacing becomes a standard treatment option.