Oxford University Press
Europace
,  volume 26 ,  issue 11

Multipoint pacing is associated with improved prognosis and cardiac resynchronization therapy response. MORE-CRT MPP randomized study secondary analyses.

Leonardo Calo 1, 2
, 
Ermenegildo De Ruvo 1, 2
, 
Christof Kolb 3, 4
, 
Amir Janmohamed 5, 6
, 
Pedro Marques 7, 8
, 
Giovanni Rovaris 9, 10
, 
Marquie Christelle 11, 12
, 
O Piot 13, 14
, 
Andrea Grammatico 15, 16
, 
Kwangdeok Lee 17, 18
, 
Wenjiao Lin 17, 18
, 
Haran Burri 19, 20
, 
Johannes Sperzel 21, 22
, 
Bernard Thibault 23, 24
, 
Christopher A. Rinaldi 25, 26
, 
Christophe Leclercq 27, 28
1
 
Policlinico Casilino , Rome ,
2
 
Division of Cardiology, Policlinico Casilino , Rome ,
3
 
4
 
5
 
Rouge Valley Centenary , Toronto, Ontario ,
6
 
Department of Cardiology, Rouge Valley Centenary , Toronto, ON , | 
7
 
8
 
9
 
10
 
11
 
12
 
13
 
Centre Cardiologique Du Nord , Saint-Denis ,
14
 
Cardiology Department, Centre Cardiologique Du Nord , Saint-Denis ,
15
 
Abbott Medical Affairs , Rome ,
16
 
Medical Affairs , Abbott, Rome ,
17
 
Abbott Clinical , Plano , | 
18
 
Clinical Affairs , Abbott, Plano , | 
19
 
20
 
21
 
22
 
23
 
24
 
25
 
St. Thomas Hospital , London ,
26
 
Department of Cardiology, St Thomas' Hospital , Guy's and St Thomas' NHS Foundation Trust, London ,
27
 
CHRU Hopital de Pontchaillou , Rennes , | 
28
 
Service de Cardiologie et Maladies Vasculaires, CHRU Hopital de Pontchaillou , Rennes , | 
Publication type: Journal Article
Publication date: 2024-10-04
Oxford University Press
scimago Q1
wos Q1
SJR: 3.057
CiteScore: 12.6
Impact factor: 7.4
ISSN: 10995129, 15322092
Abstract
Background and Aims

Cardiac resynchronization therapy (CRT) via biventricular (BIV) pacing is indicated in patients with heart failure (HF), reduced ejection fraction and prolonged QRS duration. Quadripolar leads and MultiPoint Pacing (MPP) allow multiple left ventricle (LV) sites pacing. We aimed to assess clinical benefit of MPP in patients who do not respond to standard BIV pacing.

Methods

Overall 3724 patients were treated with standard BIV pacing. After 6 months, 1639 patients were considered as CRT non-responders (echo-measured relative reduction in LV end-systolic volume (LVESV) < 15%) and randomized to MPP or BIV.

Results

We analysed 593 randomized patients (291 MPP, 302 BIV), who had BIV pacing >97% of time before randomization and complete 12-months clinical and echocardiographic data. The endpoint, composed by freedom from cardiac death and HF hospitalizations, and by LVESV relative reduction ≥15% between randomization and 12 months, occurred more frequently in MPP (96/291 (33.0%)) vs. BIV (71/302 (23.5%), p = 0.0103), also confirmed at multivariate analysis (hazard ratio = 1.55, 95% confidence interval = 1.02-2.34, p = 0.0402 vs. BIV). HF hospitalizations occurred less frequently in MPP (14/291 (4.81%)) vs. BIV (29/302 (9.60%), incidence rate ratio = 50%, p = 0.0245). Selecting patients with large (>30 ms) dispersion of interventricular electrical delay among the 4 LV lead dipoles, reverse remodeling was more frequent in MPP (18/51 (35.3%)) vs. BIV (11/62 (17.7%), p = 0.0335).

Conclusion

In patients who do not respond to standard CRT, despite high BIV pacing percentage, MPP is associated with lower occurrence of HF hospitalizations and higher probability of reverse LV remodeling, compared with BIV pacing.

Found 
Found 

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GOST Copy
Calo L. et al. Multipoint pacing is associated with improved prognosis and cardiac resynchronization therapy response. MORE-CRT MPP randomized study secondary analyses. // Europace. 2024. Vol. 26. No. 11.
GOST all authors (up to 50) Copy
Calo L., De Ruvo E., Kolb C., Janmohamed A., Marques P., Rovaris G., Christelle M., Piot O., Grammatico A., Kwangdeok Lee, Lin W., Burri H., Sperzel J., Thibault B., Rinaldi C. A., Leclercq C. Multipoint pacing is associated with improved prognosis and cardiac resynchronization therapy response. MORE-CRT MPP randomized study secondary analyses. // Europace. 2024. Vol. 26. No. 11.
RIS |
Cite this
RIS Copy
TY - JOUR
DO - 10.1093/europace/euae259
UR - https://academic.oup.com/europace/advance-article/doi/10.1093/europace/euae259/7811169
TI - Multipoint pacing is associated with improved prognosis and cardiac resynchronization therapy response. MORE-CRT MPP randomized study secondary analyses.
T2 - Europace
AU - Calo, Leonardo
AU - De Ruvo, Ermenegildo
AU - Kolb, Christof
AU - Janmohamed, Amir
AU - Marques, Pedro
AU - Rovaris, Giovanni
AU - Christelle, Marquie
AU - Piot, O
AU - Grammatico, Andrea
AU - Kwangdeok Lee
AU - Lin, Wenjiao
AU - Burri, Haran
AU - Sperzel, Johannes
AU - Thibault, Bernard
AU - Rinaldi, Christopher A.
AU - Leclercq, Christophe
PY - 2024
DA - 2024/10/04
PB - Oxford University Press
IS - 11
VL - 26
PMID - 39365705
SN - 1099-5129
SN - 1532-2092
ER -
BibTex
Cite this
BibTex (up to 50 authors) Copy
@article{2024_Calo,
author = {Leonardo Calo and Ermenegildo De Ruvo and Christof Kolb and Amir Janmohamed and Pedro Marques and Giovanni Rovaris and Marquie Christelle and O Piot and Andrea Grammatico and Kwangdeok Lee and Wenjiao Lin and Haran Burri and Johannes Sperzel and Bernard Thibault and Christopher A. Rinaldi and Christophe Leclercq},
title = {Multipoint pacing is associated with improved prognosis and cardiac resynchronization therapy response. MORE-CRT MPP randomized study secondary analyses.},
journal = {Europace},
year = {2024},
volume = {26},
publisher = {Oxford University Press},
month = {oct},
url = {https://academic.oup.com/europace/advance-article/doi/10.1093/europace/euae259/7811169},
number = {11},
doi = {10.1093/europace/euae259}
}
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