Acute Hemodynamic Effects of Simultaneous and Sequential Multi-Point Pacing in Heart Failure Patients With an Expected Higher Rate of Sub-response to Cardiac Resynchronization Therapy: Results of Multicenter SYNSEQ Study
The aim of the SYNSEQ (Left Ventricular Synchronous vs. Sequential MultiSpot Pacing for CRT) study was to evaluate the acute hemodynamic response (AHR) of simultaneous (3P-MPP syn) or sequential (3P-MPP seq) multi-3-point-left-ventricular (LV) pacing vs. single point pacing (SPP) in a group of patie...
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| Format: | Article |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.901267/full |
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| author | Maciej Sterliński Joanna Zakrzewska-Koperska Aleksander Maciąg Adam Sokal Joaquin Osca-Asensi Lingwei Wang Vasiliki Spyropoulou Baerbel Maus Francesca Lemme Osita Okafor Berthold Stegemann Richard Cornelussen Francisco Leyva |
| author_facet | Maciej Sterliński Joanna Zakrzewska-Koperska Aleksander Maciąg Adam Sokal Joaquin Osca-Asensi Lingwei Wang Vasiliki Spyropoulou Baerbel Maus Francesca Lemme Osita Okafor Berthold Stegemann Richard Cornelussen Francisco Leyva |
| author_sort | Maciej Sterliński |
| collection | DOAJ |
| description | The aim of the SYNSEQ (Left Ventricular Synchronous vs. Sequential MultiSpot Pacing for CRT) study was to evaluate the acute hemodynamic response (AHR) of simultaneous (3P-MPP syn) or sequential (3P-MPP seq) multi-3-point-left-ventricular (LV) pacing vs. single point pacing (SPP) in a group of patients at risk of a suboptimal response to cardiac resynchronization therapy (CRT). Twenty five patients with myocardial scar or QRS ≤ 150 or the absence of LBBB (age: 66 ± 12 years, QRS: 159 ± 12 ms, NYHA class II/III, LVEF ≤ 35%) underwent acute hemodynamic assessment by LV + dP/dtmax with a variety of LV pacing configurations at an optimized AV delay. The change in LV + dP/dt max (%ΔLV + dP/dt max) with 3P-MPP syn (15.6%, 95% CI: 8.8%-22.5%) was neither statistically significantly different to 3P-MPP seq (11.8%, 95% CI: 7.6-16.0%) nor to SPP basal (11.5%, 95% CI:7.1-15.9%) or SPP mid (12.2%, 95% CI:7.9-16.5%), but higher than SPP apical (10.6%, 95% CI:5.3-15.9%, p = 0.03). AHR (defined as a %ΔLV + dP/dt max ≥ 10%) varied between pacing configurations: 36% (9/25) for SPP apical, 44% (11/25) for SPP basal, 54% (13/24) for SPP mid, 56% (14/25) for 3P-MPP syn and 48% (11/23) for 3P-MPP seq.Fifteen patients (15/25, 60%) had an AHR in at least one pacing configuration. AHR was observed in 10/13 (77%) patients with a LBBB but only in 5/12 (42%) patients with a non-LBBB (p = 0.11). To conclude, simultaneous or sequential multipoint pacing compared to single point pacing did not improve the acute hemodynamic effect in a suboptimal CRT response population.Clinical Trial RegistrationClinicalTrials.gov, identifier: NCT02914457. |
| first_indexed | 2024-12-12T09:30:13Z |
| format | Article |
| id | doaj.art-84fa3fcd514e40f0989f30f4b2f91fe8 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-12T09:30:13Z |
| publishDate | 2022-05-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-84fa3fcd514e40f0989f30f4b2f91fe82022-12-22T00:28:53ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.901267901267Acute Hemodynamic Effects of Simultaneous and Sequential Multi-Point Pacing in Heart Failure Patients With an Expected Higher Rate of Sub-response to Cardiac Resynchronization Therapy: Results of Multicenter SYNSEQ StudyMaciej Sterliński0Joanna Zakrzewska-Koperska1Aleksander Maciąg2Adam Sokal3Joaquin Osca-Asensi4Lingwei Wang5Vasiliki Spyropoulou6Baerbel Maus7Francesca Lemme8Osita Okafor9Berthold Stegemann10Richard Cornelussen11Francisco Leyva12First Department of Arrhythmia, National Institute of Cardiology, Warsaw, PolandFirst Department of Arrhythmia, National Institute of Cardiology, Warsaw, PolandSecond Department of Arrhythmia, National Institute of Cardiology, Warsaw, PolandDepartment of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center of Heart Disease, Zabrze, PolandCardiology Department, University and Polytechnic Hospital la Fe, Valencia, SpainSection of Arrhythmias, Department of Cardiology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, SwedenBakken Research Center, Medtronic plc, Maastricht, NetherlandsBakken Research Center, Medtronic plc, Maastricht, NetherlandsBakken Research Center, Medtronic plc, Maastricht, NetherlandsQueen Elisabeth Hospital, Birmingham University, Birmingham, United KingdomAston Medical School, Aston Medical Research Institute, Aston University, Birmingham, United KingdomBakken Research Center, Medtronic plc, Maastricht, NetherlandsAston Medical School, Aston Medical Research Institute, Aston University, Birmingham, United KingdomThe aim of the SYNSEQ (Left Ventricular Synchronous vs. Sequential MultiSpot Pacing for CRT) study was to evaluate the acute hemodynamic response (AHR) of simultaneous (3P-MPP syn) or sequential (3P-MPP seq) multi-3-point-left-ventricular (LV) pacing vs. single point pacing (SPP) in a group of patients at risk of a suboptimal response to cardiac resynchronization therapy (CRT). Twenty five patients with myocardial scar or QRS ≤ 150 or the absence of LBBB (age: 66 ± 12 years, QRS: 159 ± 12 ms, NYHA class II/III, LVEF ≤ 35%) underwent acute hemodynamic assessment by LV + dP/dtmax with a variety of LV pacing configurations at an optimized AV delay. The change in LV + dP/dt max (%ΔLV + dP/dt max) with 3P-MPP syn (15.6%, 95% CI: 8.8%-22.5%) was neither statistically significantly different to 3P-MPP seq (11.8%, 95% CI: 7.6-16.0%) nor to SPP basal (11.5%, 95% CI:7.1-15.9%) or SPP mid (12.2%, 95% CI:7.9-16.5%), but higher than SPP apical (10.6%, 95% CI:5.3-15.9%, p = 0.03). AHR (defined as a %ΔLV + dP/dt max ≥ 10%) varied between pacing configurations: 36% (9/25) for SPP apical, 44% (11/25) for SPP basal, 54% (13/24) for SPP mid, 56% (14/25) for 3P-MPP syn and 48% (11/23) for 3P-MPP seq.Fifteen patients (15/25, 60%) had an AHR in at least one pacing configuration. AHR was observed in 10/13 (77%) patients with a LBBB but only in 5/12 (42%) patients with a non-LBBB (p = 0.11). To conclude, simultaneous or sequential multipoint pacing compared to single point pacing did not improve the acute hemodynamic effect in a suboptimal CRT response population.Clinical Trial RegistrationClinicalTrials.gov, identifier: NCT02914457.https://www.frontiersin.org/articles/10.3389/fcvm.2022.901267/fullheart failurebiventricular pacingquadripolar lead for left ventricle pacingmultipoint pacingacute hemodynamic effectcardiac resynchronization therapy |
| spellingShingle | Maciej Sterliński Joanna Zakrzewska-Koperska Aleksander Maciąg Adam Sokal Joaquin Osca-Asensi Lingwei Wang Vasiliki Spyropoulou Baerbel Maus Francesca Lemme Osita Okafor Berthold Stegemann Richard Cornelussen Francisco Leyva Acute Hemodynamic Effects of Simultaneous and Sequential Multi-Point Pacing in Heart Failure Patients With an Expected Higher Rate of Sub-response to Cardiac Resynchronization Therapy: Results of Multicenter SYNSEQ Study Frontiers in Cardiovascular Medicine heart failure biventricular pacing quadripolar lead for left ventricle pacing multipoint pacing acute hemodynamic effect cardiac resynchronization therapy |
| title | Acute Hemodynamic Effects of Simultaneous and Sequential Multi-Point Pacing in Heart Failure Patients With an Expected Higher Rate of Sub-response to Cardiac Resynchronization Therapy: Results of Multicenter SYNSEQ Study |
| title_full | Acute Hemodynamic Effects of Simultaneous and Sequential Multi-Point Pacing in Heart Failure Patients With an Expected Higher Rate of Sub-response to Cardiac Resynchronization Therapy: Results of Multicenter SYNSEQ Study |
| title_fullStr | Acute Hemodynamic Effects of Simultaneous and Sequential Multi-Point Pacing in Heart Failure Patients With an Expected Higher Rate of Sub-response to Cardiac Resynchronization Therapy: Results of Multicenter SYNSEQ Study |
| title_full_unstemmed | Acute Hemodynamic Effects of Simultaneous and Sequential Multi-Point Pacing in Heart Failure Patients With an Expected Higher Rate of Sub-response to Cardiac Resynchronization Therapy: Results of Multicenter SYNSEQ Study |
| title_short | Acute Hemodynamic Effects of Simultaneous and Sequential Multi-Point Pacing in Heart Failure Patients With an Expected Higher Rate of Sub-response to Cardiac Resynchronization Therapy: Results of Multicenter SYNSEQ Study |
| title_sort | acute hemodynamic effects of simultaneous and sequential multi point pacing in heart failure patients with an expected higher rate of sub response to cardiac resynchronization therapy results of multicenter synseq study |
| topic | heart failure biventricular pacing quadripolar lead for left ventricle pacing multipoint pacing acute hemodynamic effect cardiac resynchronization therapy |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.901267/full |
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