Evaluation of synchronized left ventricular pacing rate over biventricular pacing in cardiac resynchronization therapy.
J Cardiol
; 84(3): 165-169, 2024 Sep.
Article
in En
| MEDLINE
| ID: mdl-38679318
ABSTRACT
BACKGROUND:
The adaptive cardiac resynchronization therapy (aCRT) algorithm enables synchronized left ventricular pacing (sLVP) to achieve fusion with intrinsic right ventricular activation. Although sLVP presents benefits over biventricular pacing, the adequate sLVP rate for better clinical outcomes remains unclear. We aimed to assess the association between sLVP rates and clinical outcomes.METHODS:
Our study cohort included 271 consecutive patients, who underwent CRT implantation between April 2016 and August 2021.RESULTS:
We evaluated 63 patients on whom we applied the aCRT algorithm [48 men, mean age 64⯱â¯14â¯years; median follow-up period 316â¯days (interquartile range 212-809â¯days)]. At the 6-month follow-up after CRT implantation, the frequency of CRT responders was 71â¯% (nâ¯=â¯45). The sLVP rate was significantly higher in responders than in non-responders (75⯱â¯30â¯% vs. 47⯱â¯40â¯%, pâ¯=â¯0.003). Receiver operating characteristics curve analysis revealed that the optimal cut-off value during the sLVP rate was 59.4â¯% for the prediction of CRT responders (area under the curve, 0.70; sensitivity, 80â¯%; specificity, 61â¯%; positive predictive value, 84â¯%; and negative predictive value, 55â¯%). Kaplan-Meier analysis demonstrated that the higher-sLVP group (sLVP â§59.4â¯%, nâ¯=â¯43) had a better prognosis (cardiac death and heart failure hospitalization) than the lower-sLVP group (sLVP <59.4â¯%, nâ¯=â¯20) (log-rank pâ¯<â¯0.001). Multivariate Cox hazard analysis revealed that a higher sLVP rate was associated with a good prognosis (pâ¯<â¯0.001).CONCLUSIONS:
sLVP was associated with CRT response, and a higher sLVP rate (â§59.4â¯%) was important for good prognosis in patients with aCRT.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cardiac Resynchronization Therapy
/
Heart Failure
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Cardiol
Journal subject:
CARDIOLOGIA
Year:
2024
Type:
Article
Affiliation country:
Japan