Key result
Adaptive CRT is linked to ~12% lower mortality and reduced resource use vs standard BiV pacing.
Why the study?
Prior subgroup analyses suggested clinical benefits with AdaptivCRT, but a large prospective trial showed nonsignificant changes in mortality or heart failure hospitalizations.
Does adaptive biventricular and left ventricular pacing (aCRT) reduce mortality, readmissions, and healthcare costs compared to standard biventricular pacing in patients with a CRT implant?
Population
2,412 aCRT and 1,638 Standard CRT recipients from the Optum Clinformatics database
Comparison
Adaptive biventricular and left ventricular pacing vs standard biventricular pacing
Design
Retrospective real-world cohort study
Follow-up
Mean 2.4 ± 1.4 years
Authors
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May support adaptive CRT programming in practice; leaves open confirmation of mortality benefit in randomized trials.
Cohort (n=4,050)
Yes
Does adaptive biventricular and left ventricular pacing (aCRT) reduce mortality, readmissions, and healthcare costs compared to standard biventricular pacing in patients with a CRT implant?
Effect estimate: HR 0.88 (95% CI 0.80-0.96)
Absolute Event Rate: 20.02% vs 28.75%
p-value: p=<0.001
In a large real-world cohort, the use of an adaptive CRT algorithm was associated with significantly lower all-cause mortality, reduced 30-day readmissions, and lower healthcare costs compared to standard biventricular pacing.
Gold et al. (2023) conducted a cohort in Heart failure requiring cardiac resynchronization therapy (n=4,050). Adaptive Cardiac Resynchronization Therapy (aCRT) vs. Standard biventricular pacing (Standard CRT) was evaluated on All-cause mortality (HR 0.88, 95% CI 0.80-0.96, p=<0.001). Adaptive cardiac resynchronization therapy was associated with a 12% lower risk of all-cause mortality (HR 0.88) and reduced healthcare resource utilization compared to standard biventricular pacing.
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