Key result
QuickOpt proves non-inferior to echo optimization in reducing LVESV while significantly cutting optimization time.
Why the study?
Does QuickOpt optimization improve left ventricular end-systolic volume and clinical outcomes compared to echocardiographic optimization in Chinese patients with chronic heart failure treated by cardiac resynchronization?
RCT (n=392)
Double-blind
1:1 ratio
Yes
Does QuickOpt optimization improve left ventricular end-systolic volume and clinical outcomes compared to echocardiographic optimization in Chinese patients with chronic heart failure treated by cardiac resynchronization?
QuickOpt optimization provides similar long-term therapeutic effects and clinical improvements as echocardiographic optimization in CRT patients, but requires significantly less time to perform.
QuickOpt yields equivalent 12-month CRT outcomes to echocardiography but in minutes not hours; extends evidence for automated AV/VV optimization in diverse heart failure populations.
In this trial, long-term therapeutic effects and clinical improvements in Chinese chronic heart failure patients optimized by QuickOpt or echocardiography were compared for atrioventricular (AV) and interventricular (VV) delay optimizations after cardiac resynchronization therapy (CRT) with pacing (CRT-P) or with pacing and defibrillator (CRT-D) therapy. One hundred and ninety-six subjects (50%) had dilated cardiomyopathy, 108 (27.6%) had ischemic heart disease and 112 (28.6%) were hypertensive and were randomized into QuickOpt (198) or echocardiographic optimization (control) (194) groups at ≤2-weeks post-implantation. Programmed AV/VV delay was optimized at baseline and at 3 and 6 months. Left ventricular end-systolic volume (LVESV), New York Heart Association (NYHA) class, specific activity scale (SAS), and the six-minute walk tests (6MWT) were evaluated by blinded researchers at 12 months. Of the QuickOpt group, LVESV decreased significantly by 24.7% ± 33.9% compared with baseline, while LVESV of Controls decreased by 25.1% ± 36.1% (P = 0.924). NYHA class, SAS and 6MWT also improved similarly in both groups at 12 months. Mortality in both groups was not significantly different (11.0% vs 7.6%, P = 0.289). However, there was a significant difference in the time required for optimization by QuickOpt compared with echocardiography (3.33 ± 3.11 vs 58.79 ± 27.03 minutes, P < 0.000).
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Yan et al. (2018) conducted an RCT in Chronic heart failure (n=392). QuickOpt optimization vs. Echocardiographic optimization was evaluated on Reduction in left ventricular end-systolic volume (LVESV) at 12 months (p=0.924). QuickOpt optimization was non-inferior to echocardiographic optimization in reducing left ventricular end-systolic volume at 12 months (24.7% vs 25.1% reduction, P = 0.924), while significantly reducing optimization time.
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