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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

Sterliński, Maciej ; Zakrzewska-Koperska, Joanna ; Maciąg, Aleksander ; Sokal, Adam ; Osca-Asensi, Joaquin ; Wang, Lingwei LU orcid ; Spyropoulou, Vasiliki ; Maus, Baerbel ; Lemme, Francesca and Okafor, Osita , et al. (2022) In Frontiers in Cardiovascular Medicine 9. p.1-10
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/dtmax with a variety of LV pacing configurations at an optimized AV delay. The change in LV + dP/dt max (%ΔLV + dP/dt max) with 3P-MPP syn (15.6%, 95% CI: 8.8%-22.5%)... (More)

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/dtmax with a variety of LV pacing configurations at an optimized AV delay. The change in LV + dP/dt max (%ΔLV + 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 %ΔLV + 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.

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Contribution to journal
publication status
published
subject
in
Frontiers in Cardiovascular Medicine
volume
9
article number
901267
pages
1 - 10
publisher
Frontiers Media S. A.
external identifiers
  • scopus:85139112316
  • pmid:35647062
ISSN
2297-055X
DOI
10.3389/fcvm.2022.901267
language
English
LU publication?
yes
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Copyright © 2022 Sterliński, Zakrzewska-Koperska, Maciąg, Sokal, Osca-Asensi, Wang, Spyropoulou, Maus, Lemme, Okafor, Stegemann, Cornelussen and Leyva.
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b11ea000-5473-42a8-b9b6-2ff9b483ebfa
date added to LUP
2022-07-27 07:34:12
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2024-07-08 06:37:16
@article{b11ea000-5473-42a8-b9b6-2ff9b483ebfa,
  abstract     = {{<p>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/dtmax with a variety of LV pacing configurations at an optimized AV delay. The change in LV + dP/dt max (%ΔLV + 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 %ΔLV + 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.</p><p>Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT02914457.</p>}},
  author       = {{Sterliński, Maciej and Zakrzewska-Koperska, Joanna and Maciąg, Aleksander and Sokal, Adam and Osca-Asensi, Joaquin and Wang, Lingwei and Spyropoulou, Vasiliki and Maus, Baerbel and Lemme, Francesca and Okafor, Osita and Stegemann, Berthold and Cornelussen, Richard and Leyva, Francisco}},
  issn         = {{2297-055X}},
  language     = {{eng}},
  month        = {{05}},
  pages        = {{1--10}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Cardiovascular Medicine}},
  title        = {{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}},
  url          = {{http://dx.doi.org/10.3389/fcvm.2022.901267}},
  doi          = {{10.3389/fcvm.2022.901267}},
  volume       = {{9}},
  year         = {{2022}},
}