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Acute Hemodynamic Effects of Simultaneous and Sequential Multi-Point Pacing in Heart Failure Patients With an Expected Higher Rate of Sub-response to Cardiac Resynchronization Therapy: Results of Multicenter SYNSEQ Study.

Acute Hemodynamic Effects of Simultaneous and Sequential Multi-Point Pacing in Heart Failure Patients With an Expected Higher Rate of Sub-response to Cardiac Resynchronization Therapy: Results of Multicenter SYNSEQ Study.

Fecha de publicación: 01/01/2022 Fecha Ahead of Print: 12/05/2022

Autores de IIS La Fe

Joaquín Osca Asensi

Autor

Participantes ajenos a IIS La Fe

Sterlinski M
Zakrzewska-Koperska J
Maciag A
Sokal A
Wang L
Spyropoulou V
Maus B
Lemme F
Okafor O
Stegemann B
Cornelussen R
Leyva F

Grupos

Grupo de Investigación Clínica y Traslacional en Cardiología

Investigador Principal

Esther Roselló Lletí

Abstract

The aim of the SYNSEQ (Left Ventricular Synchronous vs. Sequential MultiSpot Pacing for CRT) study was to evaluate the acute hemodynamic response (AHR) of simultaneous (3P-MPP (syn)) or sequential (3P-MPP (seq)) multi-3-point-left-ventricular (LV) pacing vs. single point pacing (SPP) in a group of patients at risk of a suboptimal response to cardiac resynchronization therapy (CRT). Twenty five patients with myocardial scar or QRS = 150 or the absence of LBBB (age: 66 ± 12 years, QRS: 159 ± 12 ms, NYHA class II/III, LVEF = 35%) underwent acute hemodynamic assessment by LV + dP/dt(max) with a variety of LV pacing configurations at an optimized AV delay. The change in LV + dP/dt (max) (% LV + dP/dt (max)) with 3P-MPP (syn) (15.6%, 95% CI: 8.8%-22.5%) was neither statistically significantly different to 3P-MPP (seq) (11.8%, 95% CI: 7.6-16.0%) nor to SPP (basal) (11.5%, 95% CI:7.1-15.9%) or SPP (mid) (12.2%, 95% CI:7.9-16.5%), but higher than SPP (apical) (10.6%, 95% CI:5.3-15.9%, p = 0.03). AHR (defined as a % LV + dP/dt (max) = 10%) varied between pacing configurations: 36% (9/25) for SPP (apical), 44% (11/25) for SPP (basal), 54% (13/24) for SPP (mid), 56% (14/25) for 3P-MPP (syn) and 48% (11/23) for 3P-MPP (seq.Fifteen) patients (15/25, 60%) had an AHR in at least one pacing configuration. AHR was observed in 10/13 (77%) patients with a LBBB but only in 5/12 (42%) patients with a non-LBBB (p = 0.11). To conclude, simultaneous or sequential multipoint pacing compared to single point pacing did not improve the acute hemodynamic effect in a suboptimal CRT response population. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02914457.

Datos de la publicación

ISSN/ISSNe:: 2297-055X, 2297-055X
Tipo:: Article
Páginas:: 901267-901267
DOI:: 10.3389/fcvm.2022.901267
Factor de Impacto:: 1,443 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Sterlinski M:: First Department of Arrhythmia, National Institute of Cardiology, Warsaw, Poland
Zakrzewska-Koperska J:: First Department of Arrhythmia, National Institute of Cardiology, Warsaw, Poland
Maciag A:: Second Department of Arrhythmia, National Institute of Cardiology, Warsaw, Poland
Sokal A:: Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center of Heart Disease, Zabrze, Poland
Osca-Asensi J:: Cardiology Department, University and Polytechnic Hospital la Fe, Valencia, Spain
Wang L:: Section of Arrhythmias, Department of Cardiology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
Spyropoulou V:: Bakken Research Center, Medtronic plc, Maastricht, Netherlands
Maus B:: Bakken Research Center, Medtronic plc, Maastricht, Netherlands
Lemme F:: Bakken Research Center, Medtronic plc, Maastricht, Netherlands
Okafor O:: Queen Elisabeth Hospital, Birmingham University, Birmingham, United Kingdom
Stegemann B:: Aston Medical School, Aston Medical Research Institute, Aston University, Birmingham, United Kingdom
Cornelussen R:: Bakken Research Center, Medtronic plc, Maastricht, Netherlands
Leyva F:: Aston Medical School, Aston Medical Research Institute, Aston University, Birmingham, United Kingdom

Keywords

acute hemodynamic effect; biventricular pacing; cardiac resynchronization therapy; heart failure; multipoint pacing; quadripolar lead for left ventricle pacing