Response rate in cardiac resynchronization therapy patients implanted with a left ventricular quadripolar lead and the MultiPoint™ pacing feature early activated. QUARTO III

Autor: Joaquín Osca, Jaume Francisco‐Pascual, Javier Martínez‐Basterra, Juan Gabriel Martínez, Hipólito Reis, Mario Oliveira, Bieito Campos, Javier Balaguer, Jerónimo Rubio, Ricardo Pavón‐Jiménez, Julio Hernández, Jose Miguel Ormaetxe, Jose Luis Zamorano, Pilar Santamaría, Javier Alzueta
Rok vydání: 2022
Předmět:
Zdroj: European Journal of Clinical Investigation. 53
ISSN: 1365-2362
0014-2972
DOI: 10.1111/eci.13935
Popis: 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.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.This was a multicentre, prospective, open-label and non-randomized study. The primary endpoint was response to biventricular pacing defined as15% 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.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%.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.
Databáze: OpenAIRE
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