Format

Send to

Choose Destination

See 1 citation found by title matching your search:

Heart Rhythm. 2016 Jan;13(1):183-9. doi: 10.1016/j.hrthm.2015.08.036. Epub 2015 Sep 26.

Safety, feasibility, and outcome results of cardiac resynchronization with triple-site ventricular stimulation compared to conventional cardiac resynchronization.

Author information

1
Charles Nicolle University Hospital, Rouen, France. Electronic address: frederic.anselme@chu-rouen.fr.
2
Haut Lévèque University Hospital, Pessac, France.
3
Arnaud de Villeneuve University Hospital, Montpellier, France.
4
Cardiology Hospital, Lille, France.
5
Pontchaillou University Hospital, Rennes, France.
6
Saint Louis Hospital, La Rochelle, France.
7
Ambroise Paré Clinic, Neuilly sur Seine, France.
8
La Timone University Hospital, Marseille, France.
9
Nouvelles Cliniques Nantaises-Le Confluent, Nantes, France.
10
Laënnec University Hospital, Saint Herblain, France.
11
Centre Cardiologique du Nord, Saint-Denis, France.
12
Charles Nicolle University Hospital, Rouen, France.

Abstract

BACKGROUND:

The nonresponder rate to cardiac resynchronization therapy (CRT) may be due to incomplete resynchronization, with dyssynchrony persisting in approximately 30% of patients. We hypothesized that CRT with triple-site ventricular stimulation (TRIV) may improve resynchronization and its outcomes.

OBJECTIVE:

The purpose of this study was to assess the feasibility and safety of TRIV and collected data on clinical outcomes to dimension future studies.

METHODS:

Our pilot randomized trial was designed to assess the safety and feasibility of TRIV with 2 right ventricular leads and 1 left ventricular leads compared to conventional CRT. The primary end-point was the rate of severe adverse events at 6 months. Secondary end-points included functional improvement parameters, quality-of-life (QOL) score, and changes of echocardiographic indices at 6 and 12 months in a subset of patients.

RESULTS:

Seventy-six patients were enrolled at 11 centers and randomized to control or TRIV arm. All implant procedures but one were successful. At 6 months, there was no statistical difference between proportions of patients with at least 1 severe adverse event in both groups (34.1% vs 25.7%, P = .425). There also was no difference between functional improvement parameters, 6-minute walking distances (P = .40), QOL scores (P = .27), and echographic indices. At 12 months, the proportions of patients with a left ventricular ejection fraction gain of more than 5%, 10%, or 15% were significantly superior with TRIV.

CONCLUSION:

TRIV pacing is an effective and safe technique and may provide a greater benefit in ventricular remodeling than conventional CRT. Further studies are needed to assess its long-term benefit.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00887237.

KEYWORDS:

Cardiac resynchronization therapy; Congestive heart failure; Multisite pacing

PMID:
26325531
DOI:
10.1016/j.hrthm.2015.08.036
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science Icon for HAL archives ouvertes
Loading ...
Support Center