Meta-analysis of randomized controlled trials evaluating left ventricular vs. biventricular pacing in heart failure: effect on all-cause mortality and hospitalizations
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‐anal...
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| Veröffentlicht in: | European journal of heart failure 2012-06, Vol.14 (6), p.652-660 |
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| container_title | European journal of heart failure |
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| creator | Boriani, Giuseppe Gardini, Beatrice Diemberger, Igor Reggiani, Maria Letizia Bacchi Biffi, Mauro Martignani, Cristian Ziacchi, Matteo Valzania, Cinzia Gasparini, Maurizio Padeletti, Luigi Branzi, Angelo |
| description | 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. |
| doi_str_mv | 10.1093/eurjhf/hfs040 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1016668950</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1016668950</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4160-a7914a6f45ddefd018d82d2209f52076be6fcad1df61cd54dd476e16b536b9813</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhSMEoqWwZIu8ZJPWdhLHYQel06EaYAEIdpZjXzMuTjy1nYHpC_U161GGihWr-6PvnnukUxQvCT4luKvOYArXa3O2NhHX-FFxTHjblZjX9ePcV5yXHa_pUfEsxmuMSYsxfVocUdoQXNPquLj7CEmWcpRuF21E3qAgR-0HewsaKT-m4J3LbQpWuohgK90kkx1_IgcmoS1kwqrJyYC28RT19t_NRqo9aUe0BhkSMtK6KcAbBMaASsiPSDpXKjlFQIMPSTqbdigbQGsfN3Y_3-ZvfozPiycmG4AXh3pSfFtcfD1flqvPlx_O365KVROGS9l2pJbM1I3WYDQmXHOqKcWdaShuWQ_MKKmJNowo3dRa1y0DwvqmYn3HSXVSvJ51N8HfTBCTGGxU4JwcwU9REEwYY7xrcEbLGVXBxxjAiE2wgwy7DIl9NmLORszZZP7VQXrqB9AP9N8wMtDMwG_rYPd_NXFxtVwsF19m4YMRGxP8ebiT4ZdgbdU24vunS8F_XBG6ek_Eu-oefVqyEw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1016668950</pqid></control><display><type>article</type><title>Meta-analysis of randomized controlled trials evaluating left ventricular vs. biventricular pacing in heart failure: effect on all-cause mortality and hospitalizations</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Access via Wiley Online Library</source><source>Wiley Free Content</source><source>Alma/SFX Local Collection</source><creator>Boriani, Giuseppe ; Gardini, Beatrice ; Diemberger, Igor ; Reggiani, Maria Letizia Bacchi ; Biffi, Mauro ; Martignani, Cristian ; Ziacchi, Matteo ; Valzania, Cinzia ; Gasparini, Maurizio ; Padeletti, Luigi ; Branzi, Angelo</creator><creatorcontrib>Boriani, Giuseppe ; Gardini, Beatrice ; Diemberger, Igor ; Reggiani, Maria Letizia Bacchi ; Biffi, Mauro ; Martignani, Cristian ; Ziacchi, Matteo ; Valzania, Cinzia ; Gasparini, Maurizio ; Padeletti, Luigi ; Branzi, Angelo</creatorcontrib><description>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.</description><identifier>ISSN: 1388-9842</identifier><identifier>EISSN: 1879-0844</identifier><identifier>DOI: 10.1093/eurjhf/hfs040</identifier><identifier>PMID: 22510423</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>biventricular pacing ; Cardiac Resynchronization Therapy ; Chi-Square Distribution ; Confidence Intervals ; heart failure ; Heart Failure - mortality ; Heart Failure - therapy ; Hospitalization ; Humans ; morbidity ; mortality ; Odds Ratio ; outcome ; pacing ; Prognosis ; Randomized Controlled Trials as Topic - methods ; Stroke Volume ; Treatment Outcome ; Ventricular Function, Left</subject><ispartof>European journal of heart failure, 2012-06, Vol.14 (6), p.652-660</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © 2012 the Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4160-a7914a6f45ddefd018d82d2209f52076be6fcad1df61cd54dd476e16b536b9813</citedby><cites>FETCH-LOGICAL-c4160-a7914a6f45ddefd018d82d2209f52076be6fcad1df61cd54dd476e16b536b9813</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1093%2Feurjhf%2Fhfs040$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1093%2Feurjhf%2Fhfs040$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22510423$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boriani, Giuseppe</creatorcontrib><creatorcontrib>Gardini, Beatrice</creatorcontrib><creatorcontrib>Diemberger, Igor</creatorcontrib><creatorcontrib>Reggiani, Maria Letizia Bacchi</creatorcontrib><creatorcontrib>Biffi, Mauro</creatorcontrib><creatorcontrib>Martignani, Cristian</creatorcontrib><creatorcontrib>Ziacchi, Matteo</creatorcontrib><creatorcontrib>Valzania, Cinzia</creatorcontrib><creatorcontrib>Gasparini, Maurizio</creatorcontrib><creatorcontrib>Padeletti, Luigi</creatorcontrib><creatorcontrib>Branzi, Angelo</creatorcontrib><title>Meta-analysis of randomized controlled trials evaluating left ventricular vs. biventricular pacing in heart failure: effect on all-cause mortality and hospitalizations</title><title>European journal of heart failure</title><addtitle>European Journal of Heart Failure</addtitle><description>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.</description><subject>biventricular pacing</subject><subject>Cardiac Resynchronization Therapy</subject><subject>Chi-Square Distribution</subject><subject>Confidence Intervals</subject><subject>heart failure</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - therapy</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>morbidity</subject><subject>mortality</subject><subject>Odds Ratio</subject><subject>outcome</subject><subject>pacing</subject><subject>Prognosis</subject><subject>Randomized Controlled Trials as Topic - methods</subject><subject>Stroke Volume</subject><subject>Treatment Outcome</subject><subject>Ventricular Function, Left</subject><issn>1388-9842</issn><issn>1879-0844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhSMEoqWwZIu8ZJPWdhLHYQel06EaYAEIdpZjXzMuTjy1nYHpC_U161GGihWr-6PvnnukUxQvCT4luKvOYArXa3O2NhHX-FFxTHjblZjX9ePcV5yXHa_pUfEsxmuMSYsxfVocUdoQXNPquLj7CEmWcpRuF21E3qAgR-0HewsaKT-m4J3LbQpWuohgK90kkx1_IgcmoS1kwqrJyYC28RT19t_NRqo9aUe0BhkSMtK6KcAbBMaASsiPSDpXKjlFQIMPSTqbdigbQGsfN3Y_3-ZvfozPiycmG4AXh3pSfFtcfD1flqvPlx_O365KVROGS9l2pJbM1I3WYDQmXHOqKcWdaShuWQ_MKKmJNowo3dRa1y0DwvqmYn3HSXVSvJ51N8HfTBCTGGxU4JwcwU9REEwYY7xrcEbLGVXBxxjAiE2wgwy7DIl9NmLORszZZP7VQXrqB9AP9N8wMtDMwG_rYPd_NXFxtVwsF19m4YMRGxP8ebiT4ZdgbdU24vunS8F_XBG6ek_Eu-oefVqyEw</recordid><startdate>201206</startdate><enddate>201206</enddate><creator>Boriani, Giuseppe</creator><creator>Gardini, Beatrice</creator><creator>Diemberger, Igor</creator><creator>Reggiani, Maria Letizia Bacchi</creator><creator>Biffi, Mauro</creator><creator>Martignani, Cristian</creator><creator>Ziacchi, Matteo</creator><creator>Valzania, Cinzia</creator><creator>Gasparini, Maurizio</creator><creator>Padeletti, Luigi</creator><creator>Branzi, Angelo</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201206</creationdate><title>Meta-analysis of randomized controlled trials evaluating left ventricular vs. biventricular pacing in heart failure: effect on all-cause mortality and hospitalizations</title><author>Boriani, Giuseppe ; Gardini, Beatrice ; Diemberger, Igor ; Reggiani, Maria Letizia Bacchi ; Biffi, Mauro ; Martignani, Cristian ; Ziacchi, Matteo ; Valzania, Cinzia ; Gasparini, Maurizio ; Padeletti, Luigi ; Branzi, Angelo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4160-a7914a6f45ddefd018d82d2209f52076be6fcad1df61cd54dd476e16b536b9813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>biventricular pacing</topic><topic>Cardiac Resynchronization Therapy</topic><topic>Chi-Square Distribution</topic><topic>Confidence Intervals</topic><topic>heart failure</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - therapy</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>morbidity</topic><topic>mortality</topic><topic>Odds Ratio</topic><topic>outcome</topic><topic>pacing</topic><topic>Prognosis</topic><topic>Randomized Controlled Trials as Topic - methods</topic><topic>Stroke Volume</topic><topic>Treatment Outcome</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boriani, Giuseppe</creatorcontrib><creatorcontrib>Gardini, Beatrice</creatorcontrib><creatorcontrib>Diemberger, Igor</creatorcontrib><creatorcontrib>Reggiani, Maria Letizia Bacchi</creatorcontrib><creatorcontrib>Biffi, Mauro</creatorcontrib><creatorcontrib>Martignani, Cristian</creatorcontrib><creatorcontrib>Ziacchi, Matteo</creatorcontrib><creatorcontrib>Valzania, Cinzia</creatorcontrib><creatorcontrib>Gasparini, Maurizio</creatorcontrib><creatorcontrib>Padeletti, Luigi</creatorcontrib><creatorcontrib>Branzi, Angelo</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boriani, Giuseppe</au><au>Gardini, Beatrice</au><au>Diemberger, Igor</au><au>Reggiani, Maria Letizia Bacchi</au><au>Biffi, Mauro</au><au>Martignani, Cristian</au><au>Ziacchi, Matteo</au><au>Valzania, Cinzia</au><au>Gasparini, Maurizio</au><au>Padeletti, Luigi</au><au>Branzi, Angelo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Meta-analysis of randomized controlled trials evaluating left ventricular vs. biventricular pacing in heart failure: effect on all-cause mortality and hospitalizations</atitle><jtitle>European journal of heart failure</jtitle><addtitle>European Journal of Heart Failure</addtitle><date>2012-06</date><risdate>2012</risdate><volume>14</volume><issue>6</issue><spage>652</spage><epage>660</epage><pages>652-660</pages><issn>1388-9842</issn><eissn>1879-0844</eissn><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.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>22510423</pmid><doi>10.1093/eurjhf/hfs040</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of heart failure, 2012-06, Vol.14 (6), p.652-660 |
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| subjects | biventricular pacing Cardiac Resynchronization Therapy Chi-Square Distribution Confidence Intervals heart failure Heart Failure - mortality Heart Failure - therapy Hospitalization Humans morbidity mortality Odds Ratio outcome pacing Prognosis Randomized Controlled Trials as Topic - methods Stroke Volume Treatment Outcome Ventricular Function, Left |
| title | Meta-analysis of randomized controlled trials evaluating left ventricular vs. biventricular pacing in heart failure: effect on all-cause mortality and hospitalizations |
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