Essential Site Maintenance: Authorea-powered sites will be updated circa 15:00-17:00 Eastern on Tuesday 5 November.
There should be no interruption to normal services, but please contact us at [email protected] in case you face any issues.

loading page

QUARTO III. Response rate in cardiac resynchronization therapy patients implanted with a left ventricular quadripolar lead and the MultiPoint TM Pacing feature activated.
  • +12
  • Joaquín Osca,
  • Jaume Francisco-Pascual,
  • Javier Martínez-Basterra,
  • Juan Gabriel Martinez,
  • Hipólito Reis,
  • Mario Oliveira,
  • Bieito Campos,
  • Javier Balaguer,
  • Jerónimo Rubio Sanz,
  • Ricardo Pavón-Jiménez,
  • Julio Hernández Afonso,
  • Jose Miguel Ormaetxe,
  • Jose Zamorano,
  • Pilar Santamaría,
  • Javier Alzueta
Joaquín Osca
Hospital Universitari i Politecnic La Fe

Corresponding Author:[email protected]

Author Profile
Jaume Francisco-Pascual
Hospital Universitari Vall d'Hebron
Author Profile
Javier Martínez-Basterra
Clinica Universidad de Navarra
Author Profile
Juan Gabriel Martinez
Hospital General Universitari d'Alacant
Author Profile
Hipólito Reis
Hospital de Santo Antonio dos Capuchos
Author Profile
Mario Oliveira
Hospital Santa Marta
Author Profile
Bieito Campos
Hospital Universitari Arnau de Vilanova
Author Profile
Javier Balaguer
Hospital General Universitario de Guadalajara
Author Profile
Jerónimo Rubio Sanz
Hospital Clinico Universitario de Valladolid Servicio de Cardiologia
Author Profile
Ricardo Pavón-Jiménez
Hospital Universitario de Valme
Author Profile
Julio Hernández Afonso
Hospital Universitario Nuestra Senora de la Candelaria
Author Profile
Jose Miguel Ormaetxe
Hospital Universitario Basurto
Author Profile
Jose Zamorano
MDLZ Espana Madrid
Author Profile
Pilar Santamaría
Abbott Cardiovascular Espana SA
Author Profile
Javier Alzueta
Hospital Universitario Virgen de la Victoria
Author Profile

Abstract

BACKGROUND: Although cardiac resynchronization therapy (CRT) is beneficial in most heart failure patients, up to 40% do not respond to CRT. It has been suggested that multipoint left ventricle pacing (MPP) would increase the response rate. AIM: To assess the CRT response rate at 6 months in patients implanted with a CRT device with the MPP feature activated early after the implant. METHODS This was a multicentre, prospective, open-label and non-randomized study. The primary endpoint was response to biventricular pacing defined as >15% relative reduction in left ventricular end-systolic volume (LVESV) comparing echocardiography measurements performed at baseline and 6 months by a core laboratory. Among secondary endpoints the combined endpoint of mortality or all-cause hospitalizations was evaluated. Primary study endpoint and clinical outcomes were compared to a Quarto II control cohort. RESULTS: 105 patients were included. The response rate was 64.6% (97.5% lower confidence bound 53%). Mean relative reduction in LVESV was 25.3% and mean absolute increase in LVEF was 9.4%. The subjects with device programmed using anatomical approach had showed a trend toward higher responder rate than those using the electrical approach (72% vs. 61.1%, p= 0.32). Compared with Quarto II, the combined endpoint of mortality and or all-cause hospitalizations was lower in Quarto III (12.4% vs 25.4%, p=0.004). CONCLUSIONS: Early activation of MPP was not associated to an advantage increasing echocardiography responders to CRT at 6 months of follow up. Nevertheless, MPP was associated with better clinical outcomes in comparison to a historical control cohort. Patients programmed using widest pacing cathodes had a numerically higher responder rate.