Long-term reverse remodeling and clinical improvement by MultiPoint Pacing in a randomized, international, Middle Eastern heart failure study

Autor: Abdurahman Jamiel, Mohammed Hashim, Antonio Sorgente, Bandar Al Ghamdi, Amjad Al-Mandalawi, Raed Sweidan, Ahmad Hersi, Haitham Alanazi, Edmon Benjamin Khammo, Ismail Al Abri, Mohammad Mehdi Amin, Mohamed ElMaghawry, Abdulmohsen Almusaad, Nima Badie, Najib Alrawahi, Maria Luisa Loricchio, Alexandre Chami, Ahmed Al Fagih, Ghaliah Al Mohanny, Yahya Alhebaishi, Nazar Sudan, Fayez Bokhari, Naeem A. Alshoaibi, Mohamed Sayed
Rok vydání: 2021
Předmět:
Zdroj: Journal of Interventional Cardiac Electrophysiology. 63:399-407
ISSN: 1572-8595
1383-875X
Popis: Purpose Cardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing (MultiPoint™ Pacing, MPP) has been shown to improve CRT response, although MPP response using automated pacing vector programming has not been demonstrated in the Middle East. The purpose of this study was to compare the impact of MPP to conventional biventricular pacing (BiV) using echocardiographic and clinical changes at 6-month post-implant. Methods This prospective, randomized study was conducted at 13 Middle Eastern centers. After de novo CRT-D implant (Abbott Unify Quadra MP™ or Quadra Assura MP™) with quadripolar LV lead (Abbott Quartet™), patients were randomized to either BiV or MPP therapy. In BiV patients, the LV pacing vector was selected per standard practice; in MPP patients, the two LV pacing vectors were selected automatically using VectSelect. CRT response was defined at 6-month post-implant by a reduction in LV end-systolic volume (ESV) ≥ 15%. Results One hundred and forty-two patients (61 years old, 68% male, NYHA class II/III/IV 19%/75%/6%, 33% ischemic, 57% hypertension, 52% diabetes, 158 ms QRS, 25.8% ejection fraction [EF]) were randomized to either BiV (N = 69) or MPP (N = 73). After 6 months, MPP vs. BiV patients experienced greater ESV reduction (25.0% vs. 15.3%, P = 0.08), greater EF improvement (11.9% vs. 8.6%, P = 0.36), significantly greater ESV response rate (68.5% vs. 50.7%, P = 0.04), and significantly greater NYHA class improvement rate (80.8% vs. 60.3%, P = 0.01). Conclusions With MPP and automatic LV vector selection, more CRT patients in the Middle East experienced reverse remodeling and clinical improvement relative to conventional BiV pacing.
Databáze: OpenAIRE
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