Among patients with nonischemic cardiomyopathy receiving fusion CRT pacing, 31% achieved super-response, which was predicted by higher baseline LVEF (P=0.02) and lower pulmonary pressure (P=0.003).
Cohort (n=83)
Yes
What are the predictors of super-response to Fusion CRT pacing in patients with nonischemic cardiomyopathy and normal AV conduction?
In patients with nonischemic cardiomyopathy and normal AV conduction receiving fusion CRT pacing, higher baseline LVEF and lower pulmonary arterial systolic pressure independently predict super-response.
Background: Fusion CRT pacing (FCRT) is noninferior to biventricular pacing, according to the current data. The aim of this study is to assess the response to FCRT and to identify predictors of super-responders (SRs) in a nonischemic population with normal AV conduction. Methods: LV-only CRT patients (pts) with a right atrium/left ventricle pacing system implanted in two CRT centers in Romania were included. Device interrogation, exercise tests, echocardiography, and individualized drug optimization were performed every 6 months during close follow-up. SRs pts were defined as those with left ventricular end-systolic volume (LVESV) improvement ≥30% and stable ejection fraction (LVEF) ≥45%. Results: A total of 25 out of 83 pts (31%) were SRs, with nonischemic LBBB low EF cardiomyopathy (50 male, 62 ± 9 y.o.) initially included. Mean follow-up was 5 years ± 27 months. Patients were divided in two groups: SRs and non-SRs (52 responders/6 hypo-responders). Two predictors were found in the SRs group: a higher baseline LVEF (SRs 29 ± 5% vs. non-SRs 26 ± 5%, p = 0.02) and a lower pulmonary arterial systolic pressure (SRs 38 ± 11 mm Hg vs. non-SRs 50 ± 15 mmHg, p = 0.003). Baseline severe mitral regurgitation was found in 11% of SRs vs. 64% in the non-SRs group. Conclusions: SRs in the selected NICM-FCRT group are significative high. Higher baseline LVEF and mild pulmonary arterial hypertension were independently associated with super-response.
Goanță et al. (Tue,) conducted a cohort in Nonischemic LBBB low EF cardiomyopathy with normal AV conduction (n=83). Fusion CRT pacing (FCRT) was evaluated on Super-response (LVESV improvement ≥30% and stable LVEF ≥45%). Among patients with nonischemic cardiomyopathy receiving fusion CRT pacing, 31% achieved super-response, which was predicted by higher baseline LVEF (P=0.02) and lower pulmonary pressure (P=0.003).