Impact of physiologic pacing versus right ventricular pacing among patients with left ventricular ejection fraction greater than 35%: A systematic review.

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Impact of physiologic pacing versus right ventricular pacing among patients with left ventricular ejection fraction greater than 35%: A systematic review for the 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay David J. Slotwiner, MD, FACC, FHRS, Merritt H. Raitt, MD, FACC, FHRS, Freddy Del-Carpio Munoz, MD, MSc, FHRS, Siva K. Mulpuru, MD, FACC, Naseer Nasser, MD, Pamela N. Peterson, MD, MSPH, FACC Heart Rhythm DOI: 10.1016/j.hrthm.2018.10.035 Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 1 PRISMA Diagram. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 2 Studies Included in the Meta-Analyses With Selected Results. Green-shaded boxes indicate that the results are statistically significant (p<0.05). Orange-shaded boxes indicate that only 2 studies reported results. BiV = biventricular; CI = confidence interval; LV = left ventricular; LVEF = left ventricular ejection fraction; MD = mean difference; NYHA = New York Heart Association; RR = relative risk; RV = right ventricular; RVP = right ventricular pacing; SF-36 = 36-Item Short-Form Health Survey. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 3A Forest Plots for BiVP Versus RVP, LV End-Systolic Volume. Heterogeneity is defined as: Q (df=2)=2.28; p=0.32; I2=12.31%. BiVP = biventricular pacing; FE = fixed effects; LV = left ventricular; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 3B Funnel Plot for BiVP Versus RVP, LV End-Systolic Volume. BiVP = biventricular pacing; LV = left ventricular; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 4A Forest Plots for BiVP Versus RVP, LV End-Diastolic Volume. Heterogeneity is defined as: Q (df=2)=1.78; p=0.41; I2=0%. BiVP = biventricular pacing; FE = fixed effects; LV = left ventricular; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 4B Funnel Plot for BiVP Versus RVP, LV End-Diastolic Volume. BiVP = biventricular pacing; LV = left ventricular; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 5A Forest Plot for BiVP Versus RVP, LVEF. Heterogeneity is defined as: Q (df=2)=1.88; p=0.39; I2=0%. BiVP = biventricular pacing; FE = fixed effects; LVEF = left ventricular ejection fraction; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 5B Funnel Plot for BiVP Versus RVP, LVEF. BiVP = biventricular pacing; LVEF = left ventricular ejection fraction; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 6A Forest Plot for HisBP Versus RVP, LVEF. Heterogeneity is defined as: Q (df=2)=0.77; p=0.68; I2=0%. FE = fixed effects; HisBP = His bundle pacing; LVEF = left ventricular ejection fraction; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 6B Funnel Plot for HisBP Versus RVP, LVEF. HisBP = His bundle pacing; LVEF = left ventricular ejection fraction; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 7A Forest Plot for HisBP Versus RVP, NYHA Class. Heterogeneity is defined as: Q (df=2)= 2.79; p=0.25; I2=28.40%. FE = fixed effects; HisBP = His bundle pacing; NYHA = New York Heart Association; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 7B Funnel Plot for HisBP Versus RVP, NYHA Class. HisBP = His bundle pacing; NYHA = New York Heart Association; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 8A Forest Plot for BiVP and HisBP Versus RVP, LV End-Systolic Volume. Heterogeneity is defined as: Q (df=4)=2.30; p=0.68; I2=12.98%. BiVP = biventricular pacing; FE = fixed effects; HisBP = His bundle pacing; LV = left ventricular; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 8B Funnel Plot for BiVP and HisBP Versus RVP, LV End-Systolic Volume. BiVP = biventricular pacing; HisBP = His bundle pacing; LV = left ventricular; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 9A Forest Plot for BiVP and HisBP Versus RVP, LV End-Diastolic Volume. Heterogeneity is defined as: Q (df=4)=1.91; p=0.75; I2=0%. BiVP = biventricular pacing; FE = fixed effects; HisBP = His bundle pacing; LV = left ventricular; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 9B Funnel Plot for BiVP and HisBP Versus RVP, LV End-Diastolic Volume. BiVP = biventricular pacing; HisBP = His bundle pacing; LV = left ventricular; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 10A Forest Plot for BiVP and HisBP Versus RVP, LVEF. Heterogeneity is defined as: Q (df=5)=3.28; p=0.66; I2=39.11%. BiVP = biventricular pacing; FE = fixed effects; HisBP = His bundle pacing; LVEF = left ventricular ejection fraction; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions

Figure 10B Funnel Plot for BiVP and HisBP Versus RVP, LVEF. BiVP = biventricular pacing; HisBP = His bundle pacing; LVEF = left ventricular ejection fraction; RVP = right ventricular pacing. Heart Rhythm DOI: (10.1016/j.hrthm.2018.10.035) Copyright © 2019 American College of Cardiology Foundation, the American Heart Association, Inc., and the Heart Rhythm Society Terms and Conditions