September 6, 2013EP Europace
Clinical response with adaptive CRT algorithm compared with CRT with echocardiography-optimized atrioventricular delay: a retrospective analysis of multicentre trials
Why the study?
Does the adaptive CRT algorithm improve clinical composite score compared to standard CRT with echocardiography-optimized AV delay in patients receiving CRT?
Population
751 patients receiving cardiac resynchronization therapy (aCRT: 266, historical trials: 485)
Comparison
Adaptive cardiac resynchronization therapy… vs Standard CRT with echocardiography-guided AV…
Design
Cohort
Follow-up
6 months
Authors
Discussion
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Member takes
Implication
aCRT was associated with greater CCS improvement; leaves open whether it should replace echo-optimized AV delay pending randomized confirmation.
Structured PICO
Does the adaptive CRT algorithm improve clinical composite score compared to standard CRT with echocardiography-optimized AV delay in patients receiving CRT?
P
Population
751 patients receiving cardiac resynchronization therapy (aCRT: 266, historical trials: 485)
I
Intervention
Adaptive cardiac resynchronization therapy (aCRT) algorithm providing automatic ambulatory selection between synchronized LV or BiV pacing and optimization of AV and VV delays
C
Comparator
Standard CRT with echocardiography-guided AV optimization after implant (pooled historical control from MIRACLE, MIRACLE ICD, PROSPECT, and InSync III Marquis trials)
O
Outcome
Proportion of patients who had an improved clinical composite score (CCS) at the 6-month follow-upcomposite
The adaptive CRT algorithm is associated with a significantly higher likelihood of clinical improvement at 6 months compared to standard CRT with echocardiographic AV optimization.
Cite This Study
Singh et al. (2013) studied this question.