Background: Efficacy of the cardiac resynchronization therapy (CRT) in patients with left bundle
branch block (LBBB), but QRS duration of 120–150 ms is still limited. Adaptive CRT
algorithm had shown to be more effective in patients with preserved AV conduction
but the impact of the Adaptive CRT algorithm in patients with different QRS duration
remains uncertain. Methods: Patients with LBBB and preserved AV conduction enrolled in the Adaptive CRT trial,
randomized study comparing the aCRT or echo-optimized CRT (control group), were used
in this analysis. Endpoints for this analysis were clinical composite score (CCS)
at 6 months post-implant and time to first heart failure (HF) hospitalization or death.
Results: Among the 199 patients, 80 patients (40%) had a baseline QRS of 120–150 ms. In this
subgroup, a greater proportion of aCRT patients had an improved CCS (79% vs 50%) at
6 months compared to the control group (P = .03). There was also a trend toward a lower risk of death or HF hospitalization
(hazard ratio: 0.53; 95% CI: 0.24–1.15; P = .10) in aCRT group compared to the control arm. In the wide QRS subgroup, the efficacy
was comparable in both treatment arms. Conclusion: Adaptive CRT was associated with improved patient outcomes over echo-optimized bi-ventricular
CRT in patients with preserved AV conduction, LBBB, and QRS of 120–150 ms.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Cardiac FailureAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
