PMID- 27151347
OWN - NLM
STAT- MEDLINE
DCOM- 20170606
LR  - 20170922
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 67
IP  - 18
DP  - 2016 May 10
TI  - Improvement in Clinical Outcomes With Biventricular Versus 
      Right Ventricular Pacing: The BLOCK HF Study.
PG  - 2148-2157
LID - S0735-1097(16)00939-6 [pii]
LID - 10.1016/j.jacc.2016.02.051 [doi]
AB  - BACKGROUND: Sustained right ventricular (RV) apical pacing may lead to 
      deterioration in ventricular function and an increased risk of heart failure, 
      especially in patients with pre-existing systolic dysfunction. The BLOCK HF 
      (Biventricular Versus Right Ventricular Pacing in Heart Failure Patients With 
      Atrioventricular Block) trial demonstrated that biventricular-paced patients had 
      a reduced incidence of a composite endpoint of death, heart failure-related 
      urgent care, and adverse left ventricular remodeling. OBJECTIVES: In a 
      pre-specified analysis, this study examined clinical outcomes, including clinical 
      composite score, quality of life (QOL), and change in New York Heart Association 
      (NYHA) functional classification. METHODS: The BLOCK HF trial randomized patients 
      with atrioventricular block, NYHA symptom class I to III heart failure, and left 
      ventricular ejection fraction </=50% to biventricular or RV pacing. NYHA functional 
      classification, QOL, and clinical composite score were assessed at 6, 12, 18, and 
      24 months. Bayesian statistical methods were used, with the pre-specified metric 
      of benefit being a posterior probability >/=0.95. RESULTS: Patients with 
      biventricular pacing showed greater improvement in NYHA functional class at 12 
      months, with 19% improved, 61% unchanged, and 17% worsened, compared with 
      12%/62%/23% in the RV arm. QOL was improved through 12 months. At 6 months, 
      clinical composite score was improved/unchanged/worsened in 53%/24%/24% in the 
      biventricular arm compared with 39%/33%/28% in the RV arm. This improvement in 
      clinical composite score was sustained through 24 months. CONCLUSIONS: For 
      patients with atrioventricular block and systolic dysfunction, biventricular 
      pacing not only reduces the risk of mortality/morbidity, but also leads to better 
      clinical outcomes, including improved QOL and heart failure status, compared with 
      RV pacing. (Biventricular Versus Right Ventricular Pacing in Heart Failure 
      Patients With Atrioventricular Block [BLOCK HF]; NCT00267098).
CI  - Copyright (c) 2016 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Curtis, Anne B
AU  - Curtis AB
AD  - Department of Medicine, University at Buffalo, Buffalo, New York. Electronic 
      address: abcurtis@buffalo.edu.
FAU - Worley, Seth J
AU  - Worley SJ
AD  - The Heart Group, Lancaster General Health, Lancaster, Pennsylvania.
FAU - Chung, Eugene S
AU  - Chung ES
AD  - Ohio Heart and Vascular, The Christ Hospital Health Network, Cincinnati, Ohio.
FAU - Li, Pei
AU  - Li P
AD  - Medtronic, PLC, Mounds View, Minnesota.
FAU - Christman, Shelly A
AU  - Christman SA
AD  - Medtronic, PLC, Mounds View, Minnesota.
FAU - St John Sutton, Martin
AU  - St John Sutton M
AD  - Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, 
      Philadelphia, Pennsylvania.
LA  - eng
SI  - ClinicalTrials.gov/NCT00267098
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2016 May 10;67(18):2158-2160. PMID: 27151348
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrioventricular Block/*therapy
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Defibrillators, Implantable
MH  - Double-Blind Method
MH  - Female
MH  - Heart Failure, Systolic/classification/*therapy
MH  - Humans
MH  - Male
MH  - Pacemaker, Artificial
MH  - Prospective Studies
MH  - Quality of Life
OTO - NOTNLM
OT  - atrioventricular block
OT  - biventricular pacing
OT  - cardiac resynchronization therapy
OT  - heart failure
OT  - quality of life
EDAT- 2016/05/07 06:00
MHDA- 2017/06/07 06:00
CRDT- 2016/05/07 06:00
PHST- 2015/09/17 00:00 [received]
PHST- 2016/02/18 00:00 [revised]
PHST- 2016/02/23 00:00 [accepted]
PHST- 2016/05/07 06:00 [entrez]
PHST- 2016/05/07 06:00 [pubmed]
PHST- 2017/06/07 06:00 [medline]
AID - S0735-1097(16)00939-6 [pii]
AID - 10.1016/j.jacc.2016.02.051 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2016 May 10;67(18):2148-2157. doi: 10.1016/j.jacc.2016.02.051.