Live MediSum Demo

Meta-analysis of five randomized trials (N=806) comparing conduction system pacing (CSP) versus right ventricular pacing (RVP) in patients with AV block or high anticipated pacing burden found CSP markedly reduced pacing-induced cardiomyopathy (HR 0.30) and heart-failure hospitalizations (HR 0.24), preserved left ventricular ejection fraction (mean difference +4.41%), and shortened paced QRS duration. All-cause mortality was numerically lower with CSP but did not reach statistical significance.

This trial-level meta-analysis of 13 randomized trials (2,490 patients with atrial fibrillation and heart failure) compared catheter ablation plus guideline-recommended pharmacological therapy (GRPT) versus GRPT alone. Catheter ablation was associated with lower all-cause mortality (HR 0.58), lower cardiovascular death (HR 0.52), fewer HF/AF-related adverse events (HR 0.69), improved LVEF (mean +6%), and better MLWHFQ scores (mean −12 points), with a trend toward improved 6-minute walk distance.

This JACC state-of-the-art review summarizes evidence on managing hypertrophic cardiomyopathy (HCM) across the reproductive continuum, covering preconception risk stratification, genetic counseling, antepartum surveillance, arrhythmia management, and delivery/postpartum care. It emphasizes assessment of left ventricular outflow tract obstruction, systolic function, and arrhythmia burden using tools such as CARPREG II/mWHO to guide monitoring; pregnancy is generally well tolerated in low-risk women, whereas severe obstruction or systolic dysfunction confers higher maternal–fetal risk, supporting multidisciplinary pregnancy heart team management.