Clinical outcomes with synchronized left ventricular pacing: analysis of the adaptive CRT trial

David Birnie, Bernd Lemke, Kazutaka Aonuma, Henry Krum, Kathy Lai-Fun Lee, Maurizio Gasparini, Randall C Starling, Goran Milasinovic, John Gorcsan, Mahmoud Houmsse, Athula Abeyratne, Alex Sambelashvili, David O Martin

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Abstract

Acute studies have suggested that left ventricular pacing (LVP) may have benefits over biventricular pacing (BVP). The adaptive cardiac resynchronization therapy (aCRT) algorithm provides LVP synchronized to produce fusion with the intrinsic activation when the intrinsic atrioventricular (AV) interval is normal. The randomized double-blind adaptive cardiac resynchronization therapy trial demonstrated noninferiority of the aCRT algorithm compared to echocardiography-optimized BVP (control). Objective To examine whether synchronized LVP (sLVP) resulted in better clinical outcomes. Methods First, stratification by percent sLVP ( sLVP) and multivariate Cox proportional hazards model was used to assess the relationship between sLVP and clinical outcomes. Second, outcomes were compared between patients in the aCRT arm (n = 318) and control patients (n = 160) stratified by intrinsic AV interval at randomization. Results In the aCRT arm, sLVP =50 (n = 142) was independently associated with a decreased risk of death or heart failure hospitalization (hazard ratio 0.49; 95 confidence interval 0.28-0.85; P =.012) compared with sLVP
Original languageEnglish
Pages (from-to)1368 - 1374
Number of pages7
JournalHeart Rhythm
Volume10
Issue number9
DOIs
Publication statusPublished - 2013

Cite this

Birnie, D., Lemke, B., Aonuma, K., Krum, H., Lee, K. L-F., Gasparini, M., ... Martin, D. O. (2013). Clinical outcomes with synchronized left ventricular pacing: analysis of the adaptive CRT trial. Heart Rhythm, 10(9), 1368 - 1374. https://doi.org/10.1016/j.hrthm.2013.07.007
Birnie, David ; Lemke, Bernd ; Aonuma, Kazutaka ; Krum, Henry ; Lee, Kathy Lai-Fun ; Gasparini, Maurizio ; Starling, Randall C ; Milasinovic, Goran ; Gorcsan, John ; Houmsse, Mahmoud ; Abeyratne, Athula ; Sambelashvili, Alex ; Martin, David O. / Clinical outcomes with synchronized left ventricular pacing: analysis of the adaptive CRT trial. In: Heart Rhythm. 2013 ; Vol. 10, No. 9. pp. 1368 - 1374.
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title = "Clinical outcomes with synchronized left ventricular pacing: analysis of the adaptive CRT trial",
abstract = "Acute studies have suggested that left ventricular pacing (LVP) may have benefits over biventricular pacing (BVP). The adaptive cardiac resynchronization therapy (aCRT) algorithm provides LVP synchronized to produce fusion with the intrinsic activation when the intrinsic atrioventricular (AV) interval is normal. The randomized double-blind adaptive cardiac resynchronization therapy trial demonstrated noninferiority of the aCRT algorithm compared to echocardiography-optimized BVP (control). Objective To examine whether synchronized LVP (sLVP) resulted in better clinical outcomes. Methods First, stratification by percent sLVP ( sLVP) and multivariate Cox proportional hazards model was used to assess the relationship between sLVP and clinical outcomes. Second, outcomes were compared between patients in the aCRT arm (n = 318) and control patients (n = 160) stratified by intrinsic AV interval at randomization. Results In the aCRT arm, sLVP =50 (n = 142) was independently associated with a decreased risk of death or heart failure hospitalization (hazard ratio 0.49; 95 confidence interval 0.28-0.85; P =.012) compared with sLVP",
author = "David Birnie and Bernd Lemke and Kazutaka Aonuma and Henry Krum and Lee, {Kathy Lai-Fun} and Maurizio Gasparini and Starling, {Randall C} and Goran Milasinovic and John Gorcsan and Mahmoud Houmsse and Athula Abeyratne and Alex Sambelashvili and Martin, {David O}",
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Birnie, D, Lemke, B, Aonuma, K, Krum, H, Lee, KL-F, Gasparini, M, Starling, RC, Milasinovic, G, Gorcsan, J, Houmsse, M, Abeyratne, A, Sambelashvili, A & Martin, DO 2013, 'Clinical outcomes with synchronized left ventricular pacing: analysis of the adaptive CRT trial', Heart Rhythm, vol. 10, no. 9, pp. 1368 - 1374. https://doi.org/10.1016/j.hrthm.2013.07.007

Clinical outcomes with synchronized left ventricular pacing: analysis of the adaptive CRT trial. / Birnie, David; Lemke, Bernd; Aonuma, Kazutaka; Krum, Henry; Lee, Kathy Lai-Fun; Gasparini, Maurizio; Starling, Randall C; Milasinovic, Goran; Gorcsan, John; Houmsse, Mahmoud; Abeyratne, Athula; Sambelashvili, Alex; Martin, David O.

In: Heart Rhythm, Vol. 10, No. 9, 2013, p. 1368 - 1374.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Clinical outcomes with synchronized left ventricular pacing: analysis of the adaptive CRT trial

AU - Birnie, David

AU - Lemke, Bernd

AU - Aonuma, Kazutaka

AU - Krum, Henry

AU - Lee, Kathy Lai-Fun

AU - Gasparini, Maurizio

AU - Starling, Randall C

AU - Milasinovic, Goran

AU - Gorcsan, John

AU - Houmsse, Mahmoud

AU - Abeyratne, Athula

AU - Sambelashvili, Alex

AU - Martin, David O

PY - 2013

Y1 - 2013

N2 - Acute studies have suggested that left ventricular pacing (LVP) may have benefits over biventricular pacing (BVP). The adaptive cardiac resynchronization therapy (aCRT) algorithm provides LVP synchronized to produce fusion with the intrinsic activation when the intrinsic atrioventricular (AV) interval is normal. The randomized double-blind adaptive cardiac resynchronization therapy trial demonstrated noninferiority of the aCRT algorithm compared to echocardiography-optimized BVP (control). Objective To examine whether synchronized LVP (sLVP) resulted in better clinical outcomes. Methods First, stratification by percent sLVP ( sLVP) and multivariate Cox proportional hazards model was used to assess the relationship between sLVP and clinical outcomes. Second, outcomes were compared between patients in the aCRT arm (n = 318) and control patients (n = 160) stratified by intrinsic AV interval at randomization. Results In the aCRT arm, sLVP =50 (n = 142) was independently associated with a decreased risk of death or heart failure hospitalization (hazard ratio 0.49; 95 confidence interval 0.28-0.85; P =.012) compared with sLVP

AB - Acute studies have suggested that left ventricular pacing (LVP) may have benefits over biventricular pacing (BVP). The adaptive cardiac resynchronization therapy (aCRT) algorithm provides LVP synchronized to produce fusion with the intrinsic activation when the intrinsic atrioventricular (AV) interval is normal. The randomized double-blind adaptive cardiac resynchronization therapy trial demonstrated noninferiority of the aCRT algorithm compared to echocardiography-optimized BVP (control). Objective To examine whether synchronized LVP (sLVP) resulted in better clinical outcomes. Methods First, stratification by percent sLVP ( sLVP) and multivariate Cox proportional hazards model was used to assess the relationship between sLVP and clinical outcomes. Second, outcomes were compared between patients in the aCRT arm (n = 318) and control patients (n = 160) stratified by intrinsic AV interval at randomization. Results In the aCRT arm, sLVP =50 (n = 142) was independently associated with a decreased risk of death or heart failure hospitalization (hazard ratio 0.49; 95 confidence interval 0.28-0.85; P =.012) compared with sLVP

UR - http://www.sciencedirect.com/science/article/pii/S1547527113007327

U2 - 10.1016/j.hrthm.2013.07.007

DO - 10.1016/j.hrthm.2013.07.007

M3 - Article

VL - 10

SP - 1368

EP - 1374

JO - Heart Rhythm

JF - Heart Rhythm

SN - 1547-5271

IS - 9

ER -