Population
An open-label, multicentre, non-randomized, prospective study was designed. The study included patients implanted with a CRT-D device with the MPP feature under the current ESC or ACCF/AHA/HRS Class I or Class IIa indications for CRT-D implant (including upgrades from single or dual chamber ICD or PM). The following were the main exclusion criteria to participate in the study: myocardial Infarction, unstable angina or coronary revascularization within 40 days prior the enrolment, NYHA Class IV, Cerebrovascular Accident or Transient Ischemic Attack in the 3 months prior to enrolment, life expectancy < 6 months or consideration for transplantation over the next 12 months, Primary valvular disease requiring surgical intervention and patients with persistent atrial fibrillation (AF)at the time of enrolment or 30 days prior to enrolment or permanent AF not treated with atrioventricular node ablation within 2 weeks after the CRT-D implant, pregnancy and finally, patients for whom suitable transthoracic echocardiographic images for determining the cardiac output and LV volumes cannot be obtained.
Enrolment was conducted between February 2016 and August 2018. The institutional review board at each center approved the study protocol, and written informed consent was obtained from each patient.