Conduction System vs Biventricular Pacing in Heart Failure: The PhysioSync-HF Randomized Clinical Trial - PubMed
a day ago
- #cardiac pacing
- #heart failure
- #clinical trial
- The PhysioSync-HF trial compared Conduction System Pacing (CSP) and Biventricular Pacing (BiVP) in patients with heart failure with reduced ejection fraction (HFrEF) and left bundle-branch block (LBBB).
- CSP was found to be inferior to BiVP for the primary composite outcome of death, HF hospitalizations, urgent HF visits, and change in left ventricular ejection fraction (LVEF) at 12 months.
- The study included 173 patients with a median age of 62 years, 49.7% female, and a median LVEF of 26%.
- At 12 months, CSP did not meet noninferiority criteria (OR 2.36; 95% CI, 1.37-4.06) and was associated with a higher time-to-event composite of death, HF hospitalizations, or urgent HF visits.
- LVEF improved in both groups, but more significantly with BiVP (mean difference 3.8%; 95% CI, 0.3%-7.3%).
- CSP was associated with lower total direct medical costs ($7090 less at 12 months) compared to BiVP.
- The findings do not support the routine use of CSP as a first-line resynchronization strategy in HFrEF patients with LBBB.