Ahmed Adel

NATO offers a $250,000 prize for airfield denial technologies as the alliance explores new tools amid the Russia-Ukraine war.

Nord Stream 2 AG challenges the EU's Russian gas ban, arguing it amounts to unlawful expropriation without compensation.

An analysis of Keir Starmer's reported NATO ambitions and what they could mean for the alliance's future direction.

Russia rejects Ukraine's proposal for a partial ceasefire, insisting military operations will continue until its strategic objectives are achieved.

The Vatican accuses the EU of double standards on war, warning that selective justice and moral decline are fueling global instability.

Reports suggest Valery Zaluzhny may run for Ukraine's presidency as speculation grows over a potential leadership change in Kyiv.

Germany's proposal to revoke protection for military-age Ukrainian refugees raises legal, ethical, and geopolitical questions over Europe's war strategy.

Ukraine's proposed national pantheon honoring controversial WWII nationalist figures has intensified debates over historical memory and national identity.

JD Vance's call for a defensive Ukraine strategy signals a US shift toward reducing its role as Europe shoulders more of the conflict with Russia.

Background MultiPoint Pacing (MPP) may enhance the clinical and echocardiographic response to Cardiac Resynchronization Therapy (CRT), but randomized evidence remains inconsistent. The objective of this study is to compare the efficacy and safety of MPP versus conventional biventricular (BiV) pacing in patients with heart failure and reduced ejection fraction. Methods We conducted a PROSPERO-registered (CRD420251033856) systematic review and meta-analysis of randomized controlled trials evaluating MPP versus BiV pacing. Outcomes included LVESV reduction, LVEF improvement, clinical response rate, super-response rate, and conversion to non-responder. Data were synthesized using random-effects models, and certainty was assessed with GRADE. Results Six RCTs (n = 1,766) were included. MPP significantly improved LVEF (MD 5.16%, 95% CI 3.17–7.15; P < 0.0001), clinical response rate (RR 1.35, 95% CI 1.18–1.55; P < 0.0001), and super-response rate (RR 1.54, 95% CI 1.15–2.06; P = 0.004). The pooled LVESV analysis showed a nominally significant benefit with MPP, but this was accompanied by substantial heterogeneity and a prediction interval crossing zero, limiting confidence in a universal effect; the benefit appeared more consistent in CRT-naïve patients. No significant improvement was observed in non-responder conversion (RR 0.99). Overall certainty ranged from very low to moderate. Conclusion Multipoint pacing is associated with signals of improved left ventricular reverse remodeling and higher clinical response rates compared with conventional biventricular pacing. However, the high heterogeneity and a 95% prediction interval crossing zero for LVESV reduction indicate that this effect is not consistent across all populations. MPP provides clinically meaningful benefits primarily in selected patient subgroups—particularly in CRT-naïve and responder populations—rather than serving as a universal rescue strategy for established non-responders.