A unidirectional conduction pattern on preoperative magnetocardiography strongly predicted response to cardiac resynchronization therapy compared to a multidirectional pattern (OR 69.8, p<0.001).
Cohort (n=56)
No
Does a unidirectional conduction pattern on preoperative magnetocardiography predict response to cardiac resynchronization therapy in patients with advanced heart failure?
Preoperative non-invasive magnetocardiography can strongly predict CRT response and long-term outcomes in patients with advanced heart failure.
Odds Ratio: 69.8 (95% CI 13.14–669.32)
Absolute Event Rate: 89% vs 14%
p-value: p=<0.001
BACKGROUND: Approximately one-third of patients with advanced heart failure (HF) do not respond to cardiac resynchronization therapy (CRT). We investigated whether the left ventricular (LV) conduction pattern on magnetocardiography (MCG) can predict CRT responders. METHODS AND RESULTS: This retrospective study enrolled 56 patients with advanced HF (mean ±SD LV ejection fraction LVEF 23±8%; QRS duration 145±19 ms) and MCG recorded before CRT. MCG-QRS current arrow maps were classified as multidirectional (MDC; n=28) or unidirectional (UDC; n=28) conduction based on a change of either ≥35° or <35°, respectively, in the direction of the maximal current arrow after the QRS peak. Baseline New York Heart Association functional class and LVEF were comparable between the 2 groups, but QRS duration was longer and the presence of complete left bundle branch block and LV dyssynchrony was higher in the UDC than MDC group. Six months after CRT, 30 patients were defined as responders, with significantly more in the UDC than MDC group (89% vs. 14%, respectively; P<0.001). Over a 5-year follow-up, Kaplan-Meyer analysis showed that adverse cardiac events (death or implantation of an LV assist device) were less frequently observed in the UDC than MDC group (6/28 vs. 15/28, respectively; P=0.027). Multivariate analysis revealed that UDC on MCG was the most significant predictor of CRT response (odds ratio 69.8; 95% confidence interval 13.14-669.32; P<0.001). CONCLUSIONS: Preoperative non-invasive MCG may predict the CRT response and long-term outcome after CRT.
Nakashima et al. (2020) conducted a cohort in Advanced heart failure (n=56). Unidirectional conduction (UDC) pattern on magnetocardiography vs. Multidirectional conduction (MDC) pattern on magnetocardiography was evaluated on Response to cardiac resynchronization therapy (decrease in LVESV by >15% or increase in LVEF by >10% at 6 months) (OR 69.8, 95% CI 13.14-669.32, p=<0.001). A unidirectional conduction pattern on preoperative magnetocardiography strongly predicted response to cardiac resynchronization therapy compared to a multidirectional pattern (OR 69.8, p<0.001).