Long-term benefits of biventricular pacing in congestive heart failure: results from the MUltisite STimulation in cardiomyopathy (MUSTIC) study
Key result
Biventricular pacing increases 6-minute walk distance by ~20% at 12 months in heart failure.
- P=0.0001
- n=131
Why the study?
The long-term sustainability of benefits from biventricular pacing in patients with NYHA class III heart failure and intraventricular conduction delay was unclear.
Does biventricular pacing improve functional capacity and quality of life in patients with NYHA class III heart failure and intraventricular conduction delay?
Population
131 patients with NYHA class III heart failure and intraventricular conduction delay
Comparison
Biventricular pacing vs baseline
Design
Randomized controlled study with longitudinal follow-up
Follow-up
12 months
Authors
Discussion
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Implication
Biventricular pacing provides sustained improvements in functional capacity, quality of life, and left ventricular function over 12 months in patients with NYHA class III heart failure and intraventricular conduction delay.
Key Points
- To determine the long-term clinical efficacy and safety of biventricular pacing in patients with severe congestive heart failure and ventricular conduction delays.
- Multicenter study evaluating patients with severe heart failure (NYHA class III), reduced left ventricular ejection fraction (<35%), and prolonged QRS duration (≥150 ms).
- Assessed long-term functional and clinical outcomes following an initial randomized crossover phase comparing active biventricular resynchronization with inactive pacing.
- Primary follow-up measures included six-minute walking distance, quality-of-life scores, peak oxygen uptake, and heart failure hospitalizations.
- Biventricular pacing produced sustained functional improvements, maintaining increases in six-minute walking distance and peak oxygen consumption over extended follow-up.
- Hospital admission rates for worsening heart failure were significantly lower during long-term biventricular resynchronization compared to baseline and non-paced control phases.
- Patients demonstrated durable reductions in NYHA functional class and significant long-term improvements in Minnesota Living with Heart Failure quality-of-life scores.
Study Design
Type
RCT (n=131)
Randomization
randomized
Multicenter
Yes
Structured PICO
Does biventricular pacing improve functional capacity and quality of life in patients with NYHA class III heart failure and intraventricular conduction delay?
P
Population
131 patients with NYHA class III heart failure and intraventricular conduction delay, followed longitudinally for 12 months.
I
Intervention
Biventricular (BiV) pacing
C
Comparator
Baseline (longitudinal follow-up)
O
Outcome
Sustained benefits at 9 and 12 months assessed by 6-min walked distance, peak oxygen uptake (peak VO2), quality of life by the Minnesota score, NYHA class, echocardiography, and left ventricular ejection fractionsurrogate
Main Result
p-value: p=0.0001
Biventricular pacing provides sustained improvements in functional capacity, quality of life, and left ventricular function over 12 months in patients with NYHA class III heart failure and intraventricular conduction delay.
Cite This Study
Linde et al. (2002) conducted an RCT in congestive heart failure (n=131). Biventricular pacing vs. Baseline was evaluated on 6-min walked distance (p=0.0001). Biventricular pacing maintained clinical benefits at 12 months in heart failure patients, increasing 6-minute walk distance by 20% in sinus rhythm (p=0.0001) and 17% in atrial fibrillation (p=0.004).