Comparative effects of biventricular and right ventricular pacing on clinical outcomes in atrioventricular block: a systematic review and meta-analysis.

ABSTRACT:

Background

Right ventricular (RV) pacing is the standard treatment for atrioventricular (AV) block but may impair left ventricular (LV) function over time. Biventricular (BiV) pacing offers a physiologic alternative, though prior evidence has been mixed, particularly after the BioPace trial.

Methods

PubMed, ScienceDirect, Google Scholar, and the Cochrane Library were searched through May 2025 for randomized controlled trials (RCTs) comparing BiV and RV pacing in AV block. Thirteen RCTs (n = 3,685) met the inclusion criteria. Outcomes included heart failure (HF) hospitalization, all-cause mortality, six-minute walk distance (6MWD), cardiovascular (CV) death, and LVEF (%) at follow-up.

Results

BiV pacing significantly reduced HF hospitalizations (risk ratio [RR] = 0.83,

SUBMITTER: Khalid A 

PROVIDER: S-EPMC12649102 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature