PMID- 15922268
OWN - NLM
STAT- MEDLINE
DCOM- 20051004
LR  - 20161222
IS  - 1547-5271 (Print)
IS  - 1547-5271 (Linking)
VI  - 2
IP  - 6
DP  - 2005 Jun
TI  - Cardiac resynchronization therapy in patients with right bundle branch block: 
      analysis of pooled data from the MIRACLE and Contak CD trials.
PG  - 611-5
AB  - BACKGROUND: Clinical trials of cardiac resynchronization therapy (CRT) have not 
      included many patients with right bundle branch block (RBBB). OBJECTIVES: We 
      pooled data from two randomized controlled trials of CRT (Multicenter InSync 
      Randomized Clinical Evaluation [MIRACLE] and Contak CD) in order to assess 
      outcomes of patients with RBBB. METHODS: A total of 61 patients with RBBB were 
      identified, 34 of whom were randomized to the CRT group and 27 to the control 
      group. The data from these patients were entered into a new database and 
      analyzed. RESULTS: Baseline demographics were not different between the two 
      groups (mean age 65.5 +/- 11.3 years vs 69.5 +/- 9.6 years; male gender 91% vs 
      85%; patients with coronary disease 76.5% vs 88%; QRS duration 167 ms vs 164 ms; 
      all P = NS). Outcome variables (New York Heart Association [NYHA] class, 6-minute 
      hall walk distance, peak oxygen consumption (VO2), Minnesota Living with Heart 
      Failure quality-of-life scores, left ventricular ejection fraction, and 
      norepinephrine levels) were analyzed at randomization, 3 months, and 6 months. 
      CONCLUSIONS: (1) With the exception of NYHA class, patients with RBBB as the 
      qualifying wide QRS did not derive significant benefit from CRT in any of the 
      other parameters studied at 3 or 6 months. (2) RBBB patients who received active 
      CRT showed significant improvements in NYHA class by 6 months and trends toward 
      improvement in 6-minute walk distance, quality-of-life scores, and norepinephrine 
      levels. However, control patients also showed significant improvement in NYHA 
      class by 6 months but showed no improvement in objective measurements (VO2, 
      6-minute walk distance, left ventricular ejection fraction, and norepinephrine 
      levels), consistent with a placebo effect. Analysis of a larger cohort of 
      patients with RBBB undergoing CRT may demonstrate significant benefit, but the 
      current analysis does not support the use of CRT in patients with RBBB.
FAU - Egoavil, Cesar A
AU  - Egoavil CA
AD  - Thomas Jefferson University and Jefferson Heart Institute, Philadelphia, 
      Pennsylvania 19107, USA.
FAU - Ho, Reginald T
AU  - Ho RT
FAU - Greenspon, Arnold J
AU  - Greenspon AJ
FAU - Pavri, Behzad B
AU  - Pavri BB
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
RN  - X4W3ENH1CV (Norepinephrine)
SB  - IM
CIN - Heart Rhythm. 2005 Jun;2(6):616-8. PMID: 15922269
MH  - Aged
MH  - Bundle-Branch Block/*therapy
MH  - Cardiac Pacing, Artificial/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Multicenter Studies as Topic
MH  - Norepinephrine/blood
MH  - Oxygen Consumption/physiology
MH  - Quality of Life
MH  - Randomized Controlled Trials as Topic
MH  - Stroke Volume/physiology
EDAT- 2005/06/01 09:00
MHDA- 2005/10/05 09:00
CRDT- 2005/06/01 09:00
PHST- 2005/02/09 00:00 [received]
PHST- 2005/03/15 00:00 [accepted]
PHST- 2005/06/01 09:00 [pubmed]
PHST- 2005/10/05 09:00 [medline]
PHST- 2005/06/01 09:00 [entrez]
AID - S1547-5271(05)01425-6 [pii]
AID - 10.1016/j.hrthm.2005.03.012 [doi]
PST - ppublish
SO  - Heart Rhythm. 2005 Jun;2(6):611-5. doi: 10.1016/j.hrthm.2005.03.012.