Use of biventricular pacing in atrioventricular heart block / : Biventricular pacing for heart block

Objectives The objective of this report is to systematically review the evidence for the use of BVP, as either a de novo implant or as an upgrade, in the management of AV block with normal left ventricular systolic function at the MUHC. [...] CONCLUSIONS The available evidence regarding the use of BVP in AV block patients is weak in terms of the number of studies identified, the relatively small sample sizes, and the lack of meaningful clinical outcome data and short duration of follow-up within each study. [...] However, the evidence for the routine use of BVP in heart block patients remains inconsistent,8,6,9,10 and this health technology assessment report was undertaken to review the current state of the evidence for the use of BVP versus RVP in heart block patients, differentiating between those with and without pre-existing left ventricular dysfunction. [...] The quality of the RCTs in terms of risk of bias was assessed on the basis of random sequence generation, allocation concealment, blinding of participants/personnel, blinding of outcome assessment, and incomplete outcome data using the Cochrane Collaboration’s tool for assessing risk of bias.12 Each entry for these categories assesses the risk of bias as ‘low’, ‘high’, or ‘unclear’. [...] LVEF is a measure of the percentage of blood pumped out of the left ventricle of the heart with each contraction, with values <40% indicative of left ventricular dysfunction.25 It has been reported that baseline LVEF was associated with the occurrence of left ventricular (LV) dyssynchrony during RVP treatment; for example, Pastore et al, found that LV dyssynchrony occurred in 45% of patients with