A multicenter prospective randomized controlled trial of cardiac resynchronization therapy guided by invasive dP/dt.
Acute hemodynamic response
Cardiac resynchronization therapy
Heart failure
LV reverse remodeling
Targeted lead placement
Journal
Heart rhythm O2
ISSN: 2666-5018
Titre abrégé: Heart Rhythm O2
Pays: United States
ID NLM: 101768511
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
entrez:
11
6
2021
pubmed:
12
6
2021
medline:
12
6
2021
Statut:
epublish
Résumé
No periprocedural metric has demonstrated improved cardiac resynchronization therapy (CRT) outcomes in a multicenter setting. We sought to determine if left ventricular (LV) lead placement targeted to the coronary sinus (CS) branch generating the best acute hemodynamic response (AHR) results in improved outcomes at 6 months. In this multicenter randomized controlled trial, patients were randomized to guided CRT or conventional CRT. Patients in the guided arm had LV dP/dt A total of 281 patients were recruited across 12 centers. Mean age was 70.8 ± 10.9 years and 54% had ischemic etiology. Seventy-three percent of patients in the guided arm demonstrated a reduction in LVESV of ≥15% at 6 months vs 60% in the conventional arm ( AHR determined by invasively measuring LV dP/dt
Sections du résumé
BACKGROUND
BACKGROUND
No periprocedural metric has demonstrated improved cardiac resynchronization therapy (CRT) outcomes in a multicenter setting.
OBJECTIVE
OBJECTIVE
We sought to determine if left ventricular (LV) lead placement targeted to the coronary sinus (CS) branch generating the best acute hemodynamic response (AHR) results in improved outcomes at 6 months.
METHODS
METHODS
In this multicenter randomized controlled trial, patients were randomized to guided CRT or conventional CRT. Patients in the guided arm had LV dP/dt
RESULTS
RESULTS
A total of 281 patients were recruited across 12 centers. Mean age was 70.8 ± 10.9 years and 54% had ischemic etiology. Seventy-three percent of patients in the guided arm demonstrated a reduction in LVESV of ≥15% at 6 months vs 60% in the conventional arm (
CONCLUSIONS
CONCLUSIONS
AHR determined by invasively measuring LV dP/dt
Identifiants
pubmed: 34113901
doi: 10.1016/j.hroo.2021.01.005
pii: S2666-5018(21)00007-6
pmc: PMC8183864
doi:
Types de publication
Journal Article
Langues
eng
Pagination
19-27Informations de copyright
© 2021 Heart Rhythm Society. Published by Elsevier Inc.
Références
Eur Heart J. 2007 May;28(9):1143-8
pubmed: 17449877
J Am Coll Cardiol. 2010 Aug 31;56(10):774-81
pubmed: 20797490
Europace. 2019 Sep 1;21(9):1369-1377
pubmed: 31274152
J Am Coll Cardiol. 2010 Feb 9;55(6):566-75
pubmed: 19931364
Pacing Clin Electrophysiol. 2015 May;38(5):558-64
pubmed: 25640457
J Card Fail. 2001 Jun;7(2):176-82
pubmed: 11420770
J Am Coll Cardiol. 2009 Feb 10;53(6):483-90
pubmed: 19195605
Eur J Heart Fail. 2002 Jan;4(1):83-90
pubmed: 11812668
Circ Heart Fail. 2013 May;6(3):427-34
pubmed: 23476053
Circulation. 2008 May 20;117(20):2608-16
pubmed: 18458170
JACC Cardiovasc Imaging. 2019 Aug;12(8 Pt 1):1407-1416
pubmed: 29778861
Heart Rhythm. 2014 Mar;11(3):394-401
pubmed: 24291411
Circulation. 1999 Jun 15;99(23):2993-3001
pubmed: 10368116
Circ Arrhythm Electrophysiol. 2014 Apr;7(2):251-8
pubmed: 24610742
Europace. 2014 Jun;16(6):873-9
pubmed: 24525553
Eur J Heart Fail. 2018 Jun;20(6):1039-1051
pubmed: 29457358
Eur Heart J Cardiovasc Imaging. 2013 Jul;14(7):692-9
pubmed: 23175695
J Am Coll Cardiol. 2011 Sep 6;58(11):1128-36
pubmed: 21884950
J Am Coll Cardiol. 2012 Apr 24;59(17):1509-18
pubmed: 22405632
Circ Arrhythm Electrophysiol. 2009 Oct;2(5):580-7
pubmed: 19843927
Heart Rhythm. 2013 Dec;10(12):1770-7
pubmed: 23973954
Pacing Clin Electrophysiol. 2008 May;31(5):569-74
pubmed: 18439170