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Efficacy of Cardiac Resynchronization Therapy Using Automated Dynamic Optimization and Left Ventricular-only Pacing
Journal of Korean Medical Science ; : e187-2019.
Artigo em Inglês | WPRIM | ID: wpr-765018
ABSTRACT

BACKGROUND:

Although device-based optimization has been developed to overcome the limitations of conventional optimization methods in cardiac resynchronization therapy (CRT), few real-world data supports the results of clinical trials that showed the efficacy of automatic optimization algorithms. We investigated whether CRT using the adaptive CRT algorithm is comparable to non-adaptive biventricular (BiV) pacing optimized with electrocardiogram or echocardiography-based methods.

METHODS:

Consecutive 155 CRT patients were categorized into 3 groups according to the optimization

methods:

non-adaptive BiV (n = 129), adaptive BiV (n = 11), and adaptive left ventricular (LV) pacing (n = 15) groups. Additionally, a subgroup of patients (n = 59) with normal PR interval and left bundle branch block (LBBB) was selected from the non-adaptive BiV group. The primary outcomes included cardiac death, heart transplantation, LV assist device implantation, and heart failure admission. Secondary outcomes were electromechanical reverse remodeling and responder rates at 6 months after CRT.

RESULTS:

During a median 27.5-month follow-up, there was no significant difference in primary outcomes among the 3 groups. However, there was a trend toward better outcomes in the adaptive LV group compared to the other groups. In a more rigorous comparisons among the patients with normal PR interval and LBBB, similar patterns were still observed.

CONCLUSION:

In our first Asian-Pacific real-world data, automated dynamic CRT optimization showed comparable efficacy to conventional methods regarding clinical outcomes and electromechanical remodeling.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Bloqueio de Ramo / Seguimentos / Transplante de Coração / Vírus da Imunodeficiência Bovina / Morte / Eletrocardiografia / Terapia de Ressincronização Cardíaca / Insuficiência Cardíaca Tipo de estudo: Estudo observacional / Estudo prognóstico Limite: Humanos Idioma: Inglês Revista: Journal of Korean Medical Science Ano de publicação: 2019 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Bloqueio de Ramo / Seguimentos / Transplante de Coração / Vírus da Imunodeficiência Bovina / Morte / Eletrocardiografia / Terapia de Ressincronização Cardíaca / Insuficiência Cardíaca Tipo de estudo: Estudo observacional / Estudo prognóstico Limite: Humanos Idioma: Inglês Revista: Journal of Korean Medical Science Ano de publicação: 2019 Tipo de documento: Artigo