Left ventricular-only fusion pacing versus cardiac resynchronization therapy in heart failure patients: A randomized controlled trial
| Autor: | Yangang Su, Keping Chen, Hongyang Lu, Shu Zhang, Wei Hua, Jiangang Zou, Yixiu Liang, Xue Zhang, Baopeng Tang, Lang He, Xiaohong Zhou, Farong Shen |
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| Rok vydání: | 2021 |
| Předmět: |
Cardiac function curve
medicine.medical_specialty medicine.medical_treatment Heart Ventricles left ventricular fusion pacing Cardiac resynchronization therapy Clinical Investigations Ventricular Function Left law.invention Cardiac Resynchronization Therapy Randomized controlled trial law Internal medicine medicine Humans In patient cardiovascular diseases Prospective Studies PR interval Heart Failure Ejection fraction business.industry AdaptivCRT Stroke Volume General Medicine medicine.disease medicine.anatomical_structure Treatment Outcome Ventricle Heart failure Cardiology cardiovascular system Cardiology and Cardiovascular Medicine business |
| Zdroj: | Clinical Cardiology |
| ISSN: | 1932-8737 |
| Popis: | Background It is unclear whether clinical benefits of cardiac resynchronization can be achieved by pacing only the left ventricle. Hypothesis We aimed to compare the effect of a novel adaptive left ventricular-only fusion pacing (LVP) on ventricular function with conventional biventricular pacing (BVP) in cardiac resynchronization therapy (CRT) indicated patients. Methods This prospective, randomized, multicenter study enrolled CRT-indicated patients with PR interval ≤ 200 ms who were randomized in the adaptive LVP group (using the AdaptivCRT™ algorithm with intentional non-capture right ventricular pacing) or the echocardiography-optimized BVP group. Cardiac function and echocardiography were evaluated at baseline and follow-ups. CRT super response was defined as two-fold or more increase of left ventricular ejection fraction (LVEF) or final LVEF >45%, and LV end-systolic volume (LVESV) decrease >15%, and New York Heart Association (NYHA) class improved by at least one level. Results Sixty-three patients were enrolled in the study (LVP = 34 vs. BVP = 29). At 6-month follow-up, significant improvements in LVEF, LVESV, and NYHA class were observed in both groups. The CRT super response rate was significantly higher in patients with high-percentage adaptive LV-only pacing in LVP group (68.4%) than in BVP group (36.4%, p = .04). Conclusions Adaptive LV-only pacing was comparable to BVP in improving cardiac function and clinical condition in CRT-indicated patients. This finding raises the possibility that an adaptive LVP algorithm with appropriate right ventricular sensing to fuse with intrinsic right ventricular activation in a two-lead (right atrium and left ventricle) device may provide clinical benefit in a subset of CRT patients with intact atrioventricular conduction. |
| Databáze: | OpenAIRE |
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