PMID- 22549295
OWN - NLM
STAT- MEDLINE
DCOM- 20130221
LR  - 20220317
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 14
IP  - 9
DP  - 2012 Sep
TI  - A randomized pilot study of optimization of cardiac resynchronization therapy in 
      sinus rhythm patients using a peak endocardial acceleration sensor vs. standard 
      methods.
PG  - 1324-33
LID - 10.1093/europace/eus059 [doi]
AB  - AIMS: Non-response rate to cardiac resynchronization therapy (CRT) might be 
      decreased by optimizing device programming. The Clinical Evaluation on Advanced 
      Resynchronization (CLEAR) study aimed to assess the effects of CRT with 
      automatically optimized atrioventricular (AV) and interventricular (VV) delays, 
      based on a Peak Endocardial Acceleration (PEA) signal system. METHODS AND 
      RESULTS: This multicentre, single-blind study randomized patients in a 1 : 1 
      ratio to CRT optimized either automatically by the PEA-based system, or according 
      to centres' usual practices, mostly by echocardiography. Patients had heart 
      failure (HF) New York Heart Association (NYHA) functional class III/IV, left 
      ventricular ejection fraction (LVEF) <35%, QRS duration >150 or >120 ms with 
      mechanical dyssynchrony. Follow-up was 1 year. The primary endpoint was the 
      proportion of patients who improved their condition at 1 year, based on a 
      composite of all-cause death, HF hospitalizations, NYHA class, and quality of 
      life. In all, 268 patients in sinus rhythm (63% men; mean age: 73.1 +/- 9.9 years; 
      mean NYHA: 3.0 +/- 0.3; mean LVEF: 27.1 +/- 8.1%; and mean QRS duration: 160.1 +/- 22.0 
      ms) were included and 238 patients were randomized, 123 to PEA and 115 to the 
      control group. At 1 year, 76% of patients assigned to PEA were classified as 
      improved, vs. 62% in the control group (P= 0.0285). The percentage of patients 
      with improved NYHA class was significantly (P= 0.0020) higher in the PEA group 
      than in controls. Fatal and non-fatal adverse events were evenly distributed 
      between the groups. CONCLUSION: PEA-based optimization of CRT in HF patients 
      significantly increased the proportion of patients who improved with therapy, 
      mainly through improved NYHA class, after 1 year of follow-up.
FAU - Ritter, Philippe
AU  - Ritter P
AD  - University Hospital of Bordeaux, Pessac, France. ritterph@free.fr
FAU - Delnoy, Peter Paul H M
AU  - Delnoy PP
FAU - Padeletti, Luigi
AU  - Padeletti L
FAU - Lunati, Maurizio
AU  - Lunati M
FAU - Naegele, Herbert
AU  - Naegele H
FAU - Borri-Brunetto, Alberto
AU  - Borri-Brunetto A
FAU - Silvestre, Jorge
AU  - Silvestre J
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20120501
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Cause of Death
MH  - Electrocardiography
MH  - Endocardium/*physiopathology
MH  - Female
MH  - Heart Failure/mortality/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Quality of Life
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
EDAT- 2012/05/03 06:00
MHDA- 2013/02/22 06:00
CRDT- 2012/05/03 06:00
PHST- 2012/05/03 06:00 [entrez]
PHST- 2012/05/03 06:00 [pubmed]
PHST- 2013/02/22 06:00 [medline]
AID - eus059 [pii]
AID - 10.1093/europace/eus059 [doi]
PST - ppublish
SO  - Europace. 2012 Sep;14(9):1324-33. doi: 10.1093/europace/eus059. Epub 2012 May 1.