TY - JOUR
T1 - Improving cardiac resynchronization therapy response with multipoint left ventricular pacing
T2 - Twelve-month follow-up study
AU - Pappone, Carlo
AU - Ćalović, Žarko
AU - Vicedomini, Gabriele
AU - Cuko, Amarild
AU - McSpadden, Luke C.
AU - Ryu, Kyungmoo
AU - Jordan, Caroline D.
AU - Romano, Enrico
AU - Baldi, Mario
AU - Saviano, Massimo
AU - Pappone, Alessia
AU - Vitale, Raffaele
AU - Catalano, Concetto
AU - Ciaccio, Cristiano
AU - Giannelli, Luigi
AU - Ionescu, Bogdan
AU - Petretta, Andrea
AU - Fragakis, Nikolaos
AU - Fundaliotis, Angelica
AU - Tavazzi, Luigi
AU - Santinelli, Vincenzo
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Background Cardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing (MultiPoint™ Pacing [MPP], St. Jude Medical) improves acute LV function and LV reverse remodeling at 3 months. Objective The purpose of this study was to test the hypothesis that MPP can also improve LV function at 12 months. Methods Consecutive patients receiving a CRT implant (Unify Quadra MP™ or Quadra Assura MP™ CRT-D and Quartet™ LV lead, St. Jude Medical) were randomized to receive pressure-volume (PV) loop optimized biventricular pacing with either conventional cardiac resynchronization therapy (CONV) or MPP. CRT response was defined by a reduction in end-systolic volume (ESV) 15% relative to BASELINE as determined by a blinded observer and alive status. Results Forty-four patients (New York Heart Association class III, ejection fraction [EF] 29% ± 6%, QRS 152 ± 17 ms) were enrolled and randomized to either CONV (N = 22) or MPP (N = 22). During the observation period, 2 patients died of noncardiac causes and 2 patients were lost to follow-up. After 12 months, 12 of 21 patients (57%) in the CONV group and 16 of 21 patients (76%) in the MPP group were classified as CRT responders (P =.33). ESV reduction and EF increase relative to BASELINE were significantly greater with MPP than with CONV (ESV: median -25%, interquartile range [IQR] [-39% to -20%] vs median -18%, IQR [-25% to -2%], P =.03; EF: median +15%, IQR [8% to 20%] vs median +5%, IQR [-1% to 8%], P
AB - Background Cardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing (MultiPoint™ Pacing [MPP], St. Jude Medical) improves acute LV function and LV reverse remodeling at 3 months. Objective The purpose of this study was to test the hypothesis that MPP can also improve LV function at 12 months. Methods Consecutive patients receiving a CRT implant (Unify Quadra MP™ or Quadra Assura MP™ CRT-D and Quartet™ LV lead, St. Jude Medical) were randomized to receive pressure-volume (PV) loop optimized biventricular pacing with either conventional cardiac resynchronization therapy (CONV) or MPP. CRT response was defined by a reduction in end-systolic volume (ESV) 15% relative to BASELINE as determined by a blinded observer and alive status. Results Forty-four patients (New York Heart Association class III, ejection fraction [EF] 29% ± 6%, QRS 152 ± 17 ms) were enrolled and randomized to either CONV (N = 22) or MPP (N = 22). During the observation period, 2 patients died of noncardiac causes and 2 patients were lost to follow-up. After 12 months, 12 of 21 patients (57%) in the CONV group and 16 of 21 patients (76%) in the MPP group were classified as CRT responders (P =.33). ESV reduction and EF increase relative to BASELINE were significantly greater with MPP than with CONV (ESV: median -25%, interquartile range [IQR] [-39% to -20%] vs median -18%, IQR [-25% to -2%], P =.03; EF: median +15%, IQR [8% to 20%] vs median +5%, IQR [-1% to 8%], P
KW - Abbreviations CONV conventional cardiac resynchronization therapy
KW - CRT cardiac resynchronization therapy
KW - CS coronary sinus
KW - dP/dt rate of pressure change
KW - EF ejection fraction
KW - ESV end-systolic volume
KW - IQR interquartile range
KW - LBBB left bundle branch block
KW - LV left ventricle
KW - MPP MultiPoint<sup>TM</sup> Pacing
KW - NYHA New York Heart Association
KW - PV pressure-volume
KW - RV right ventricle
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U2 - 10.1016/j.hrthm.2015.02.008
DO - 10.1016/j.hrthm.2015.02.008
M3 - Article
C2 - 25678057
AN - SCOPUS:84930327388
VL - 12
SP - 1250
EP - 1258
JO - Heart Rhythm
JF - Heart Rhythm
SN - 1547-5271
IS - 6
ER -