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In silico experiments explain the non-consistent benefit of conduction system pacing over cardiac resynchronization therapy. The need to personalize therapy
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Conduction system pacing (CSP) has emerged as an alternative treatment for patients with indication for cardiac resynchronization therapy (CRT). As opposed to biventricular CRT (BIV-CRT), which is based on left epicardial stimulation, CSP aims to restore the conduction through the His-Purkinje system pacing distally to level of block. Randomized evidence with His bundle pacing (HBP)(1–3) and left bundle branch pacing (LBBP)(4,5) is not extensive compared with the available BIV-CRT data. Non-inferiority of CSP as compared to BIV-CRT has been proven in a randomized trial (LEVEL-AT)(4); furthermore, the LBBP-RESYNC trial(5) has shown greater left ventricular (LV) ejection fraction improvement with LBBP versus BiV-CRT in non-ischemic patients with left bundle branch block (LBBB).
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GUILLEM, Maria s., PUJOL LÓPEZ, Margarida, SANCHEZ ARCINIEGAS, Jorge, MONT GIRBAU, Lluís. In silico experiments explain the non-consistent benefit of conduction system pacing over cardiac resynchronization therapy. The need to personalize therapy. _Journal of Cardiovascular Electrophysiology_. 2023. Vol. 34, núm. 4, pàgs. 994-996. [consulta: 23 de gener de 2026]. ISSN: 1045-3873. [Disponible a: https://hdl.handle.net/2445/211084]