PMID- 23614585
OWN - NLM
STAT- MEDLINE
DCOM- 20130502
LR  - 20220408
IS  - 1533-4406 (Electronic)
IS  - 0028-4793 (Linking)
VI  - 368
IP  - 17
DP  - 2013 Apr 25
TI  - Biventricular pacing for atrioventricular block and systolic dysfunction.
PG  - 1585-93
LID - 10.1056/NEJMoa1210356 [doi]
AB  - BACKGROUND: Right ventricular pacing restores an adequate heart rate in patients 
      with atrioventricular block, but high percentages of right ventricular apical 
      pacing may promote left ventricular systolic dysfunction. We evaluated whether 
      biventricular pacing might reduce mortality, morbidity, and adverse left 
      ventricular remodeling in such patients. METHODS: We enrolled patients who had 
      indications for pacing with atrioventricular block; New York Heart Association 
      (NYHA) class I, II, or III heart failure; and a left ventricular ejection 
      fraction of 50% or less. Patients received a cardiac-resynchronization pacemaker 
      or implantable cardioverter-defibrillator (ICD) (the latter if the patient had an 
      indication for defibrillation therapy) and were randomly assigned to standard 
      right ventricular pacing or biventricular pacing. The primary outcome was the 
      time to death from any cause, an urgent care visit for heart failure that 
      required intravenous therapy, or a 15% or more increase in the left ventricular 
      end-systolic volume index. RESULTS: Of 918 patients enrolled, 691 underwent 
      randomization and were followed for an average of 37 months. The primary outcome 
      occurred in 190 of 342 patients (55.6%) in the right-ventricular-pacing group, as 
      compared with 160 of 349 (45.8%) in the biventricular-pacing group. Patients 
      randomly assigned to biventricular pacing had a significantly lower incidence of 
      the primary outcome over time than did those assigned to right ventricular pacing 
      (hazard ratio, 0.74; 95% credible interval, 0.60 to 0.90); results were similar 
      in the pacemaker and ICD groups. Left ventricular lead-related complications 
      occurred in 6.4% of patients. CONCLUSIONS: Biventricular pacing was superior to 
      conventional right ventricular pacing in patients with atrioventricular block and 
      left ventricular systolic dysfunction with NYHA class I, II, or III heart 
      failure. (Funded by Medtronic; BLOCK HF ClinicalTrials.gov number, NCT00267098.).
FAU - Curtis, Anne B
AU  - Curtis AB
AD  - Department of Medicine, University at Buffalo, Buffalo General Medical Center, 
      100 High St., D2-76, Buffalo, NY 14203, USA. abcurtis@buffalo.edu
FAU - Worley, Seth J
AU  - Worley SJ
FAU - Adamson, Philip B
AU  - Adamson PB
FAU - Chung, Eugene S
AU  - Chung ES
FAU - Niazi, Imran
AU  - Niazi I
FAU - Sherfesee, Lou
AU  - Sherfesee L
FAU - Shinn, Timothy
AU  - Shinn T
FAU - Sutton, Martin St John
AU  - Sutton MS
CN  - Biventricular versus Right Ventricular Pacing in Heart Failure Patients with 
      Atrioventricular Block (BLOCK HF) Trial Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT00267098
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - N Engl J Med
JT  - The New England journal of medicine
JID - 0255562
SB  - IM
CIN - Nat Rev Cardiol. 2013 Aug;10(8):436-8. PMID: 23752697
CIN - Heart. 2014 Mar;100(5):361-2. PMID: 23842032
CIN - N Engl J Med. 2013 Aug 8;369(6):579. PMID: 23924013
CIN - N Engl J Med. 2013 Aug 8;369(6):578. PMID: 23924014
CIN - N Engl J Med. 2013 Aug 8;369(6):578-9. PMID: 23924015
CIN - Expert Rev Med Devices. 2013 Sep;10(5):591-6. PMID: 24053252
MH  - Aged
MH  - Atrioventricular Block/*therapy
MH  - *Cardiac Resynchronization Therapy/adverse effects
MH  - *Defibrillators, Implantable/adverse effects
MH  - Disease-Free Survival
MH  - Female
MH  - Heart Failure, Systolic/*therapy
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mortality
MH  - Pacemaker, Artificial/adverse effects
MH  - Stroke Volume
MH  - Treatment Outcome
EDAT- 2013/04/26 06:00
MHDA- 2013/05/03 06:00
CRDT- 2013/04/26 06:00
PHST- 2013/04/26 06:00 [entrez]
PHST- 2013/04/26 06:00 [pubmed]
PHST- 2013/05/03 06:00 [medline]
AID - 10.1056/NEJMoa1210356 [doi]
PST - ppublish
SO  - N Engl J Med. 2013 Apr 25;368(17):1585-93. doi: 10.1056/NEJMoa1210356.