In:
European Journal of Clinical Investigation, Wiley, Vol. 53, No. 4 ( 2023-04)
Abstract:
Although cardiac resynchronization therapy (CRT) is beneficial in most heart failure patients, up to 40% do not respond to CRT. It has been suggested that multipoint left ventricle pacing (MPP) would increase the response rate. Aim To assess the CRT response rate at 6 months in patients implanted with a CRT device with the MPP feature activated early after the implant. Methods This was a multicentre, prospective, open‐label and non‐randomized study. The primary endpoint was response to biventricular pacing defined as 〉 15% relative reduction in left ventricular end‐systolic volume (LVESV) comparing echocardiography measurements performed at baseline and 6 months by a core laboratory. Among secondary endpoints the combined endpoint of mortality or all‐cause hospitalizations was evaluated. Primary study endpoint and clinical outcomes were compared to a Quarto II control cohort. Results Totally, 105 patients were included. The response rate was 64.6% (97.5% lower confidence bound 53%). Mean relative reduction in LVESV was 25.3%, and mean absolute increase in LVEF was 9.4%. The subjects with device programmed using anatomical approach showed a trend towards higher responder rate than those using the electrical approach (72% vs. 61.1%, p = 0.32). Finally, the combined incidence of mortality and or all‐cause hospitalizations at 6 month was 12.4%. Conclusions Early activation of MPP was not associated to an advantage increasing echocardiography responders to CRT at 6 months of follow‐up. Nevertheless, patients programmed using widest pacing cathodes had a numerically higher responder rate. Finally, early activation of MPP was associated to a low incidence of clinical endpoints at 6 months of follow‐up.
Type of Medium:
Online Resource
ISSN:
0014-2972
,
1365-2362
Language:
English
Publisher:
Wiley
Publication Date:
2023
detail.hit.zdb_id:
2004971-7
Permalink