希浦系统起搏对老年起搏诱导性心肌病病人效果的Meta分析

doi:10.3969/j.issn.1003-9198.2024.06.005

Abstract

Abstract: Objective To evaluate the efficacy and clinical benefit of upgrading to His-Purkinje system conduction system pacing (HPCSP) in the elderly patients with pacing-induced cardiomyopathy (PICM) after right ventricular pacing (RVP). Methods The literatures on Hirsch-Purkinje system (Hirsch-Purkinje system) pacing in the patients with PICM were searched from PubMed, Cochrane Library, Web of Science, Embase, CNKI, Wanfang Data and VIP Database, based on inclusion and exclusion criteria. The relevant data on clinical efficacy and safety were extracted from the studies, and were analyzed by RevMan 5.4 software. Results A total of 8 literatures were enrolled in this study, and 185 patients were included. The successful rate of HPCSP was 95%. The results of Meta-analysis showed that, compared with baseline, patients’ left ventricular ejection fraction(MD=-11.73, 95%CI:-14.74--8.72, P<0.01)was significantly increased, QRS duration(MD=59.84, 95%CI:55.98-63.70, P<0.01)was shortened, cardiac function classification of New York Heart Association(MD=1.05, 95%CI: 0.70-1.41, P<0.01)was significantly increased. No significant differences were observed in pacing threshold (MD=-0.11, 95%CI: -0.24-0.02, P=0.08) and R-wave(MD=-0.35, 95%CI: -1.94-1.24, P=0.66) before and after the upgrading operation. Conclusions For the elderly patients with PICM, upgrading the pacing mode to HPCSP should be considered. HPCSP can correct electrical dissynchronization and ventricular remodeling caused by long-term right ventricular pacing, and can improve clinical cardiac function and reduce surgery-related complications.

Key words: His-Purkinje conduction system pacing, His bundle pacing, left bundle branch pacing, pacing-induced cardiomyopathy, aged, right ventricular pacing, Meta-analysis

CLC Number:

R541.6

CHENG Rong, ZHOU Haoyang, LI Ying, ZHANG Cheng, LI Chunyu, CHEN Yan. A Meta-analysis on the efficacy of His-Purkinje system pacing in elderly patients with pacing-induced cardiomyopathy[J]. Practical Geriatrics, 2024, 38(6): 557-563.

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A Meta-analysis on the efficacy of His-Purkinje system pacing in elderly patients with pacing-induced cardiomyopathy

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