PMID- 28906405
OWN - NLM
STAT- MEDLINE
DCOM- 20170922
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 37
DP  - 2017 Sep
TI  - Repetitive optimizing left ventricular pacing configurations with quadripolar 
      leads improves response to cardiac resynchronization therapy: A single-center 
      randomized clinical trial.
PG  - e8066
LID - 10.1097/MD.0000000000008066 [doi]
LID - e8066
AB  - BACKGROUND: This study aimed to investigate whether repetitive optimizing left 
      ventricular pacing configurations (LVPCs) with quadripolar leads (QUAD) can 
      improve response to cardiac resynchronization therapy (CRT). METHODS: Fifty-two 
      eligible patients were enrolled and 1:1 randomized to either the quadripolar LV 
      leads (QUAD) group or the conventional bipolar leads (CONV) group. In the QUAD 
      group, optimization of LVPC was performed for all patients before discharge and 
      for nonresponders at 3 months follow-up. Clinical evaluations and transthoracic 
      echocardiograms were performed before, 3, and 6 months after CRT implantation. 
      RESULTS: At 3 months follow-up, 16 of 25 (64%) patients in the CONV group (1 
      patient was lost to follow-up) and 18 of 26 (69%) patients in the QUAD group were 
      classified as responders. After optimizing the LVPCs in 3-month nonresponders in 
      the QUAD group, 21 of 26 (80.8%) patients in the QUAD group were classified as 
      responders at 6 months as compared with 17 of 25 (68%) patients in the CONV 
      group. Left ventricular end-systolic volume (LVESV) reduction, left ventricular 
      ejection fraction (LVEF) increase, and New York Heart Association (NYHA) 
      functional class reduction at 6 months were significantly greater in the QUAD 
      group than in the CONV group (LVESV: -26.9 +/- 13.8 vs -17.2 +/- 13.3%; P = .013; 
      LVEF: +12.7 +/- 8.0 vs +7.8 +/- 6.3 percentage points; P = .017; NYHA: -1.27 +/- 0.67 
      vs -0.72 +/- 0.54 functional classes; P = .002). CONCLUSIONS: Compared with 
      conventional bipolar leads, CRT using quadripolar leads with repetitive optimized 
      LVPCs resulted in an additional increase in LVEF and reduction in LVESV and NYHA 
      functional class at 6-month follow-up.
FAU - Gu, Min
AU  - Gu M
AD  - The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, 
      Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of 
      Medical Sciences and Peking Union Medical College, Beijing, China.
FAU - Jin, Han
AU  - Jin H
FAU - Hua, Wei
AU  - Hua W
FAU - Fan, Xiao-Han
AU  - Fan XH
FAU - Ding, Li-Gang
AU  - Ding LG
FAU - Wang, Jing
AU  - Wang J
FAU - Niu, Hong-Xia
AU  - Niu HX
FAU - Cai, Chi
AU  - Cai C
FAU - Zhang, Shu
AU  - Zhang S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - *Cardiac Resynchronization Therapy/methods
MH  - Double-Blind Method
MH  - Echocardiography
MH  - *Electrodes, Implanted
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
MH  - Ventricular Function, Left
PMC - PMC5604674
COIS- The authors declare that they have no conflict of interest.
EDAT- 2017/09/15 06:00
MHDA- 2017/09/25 06:00
PMCR- 2017/09/15
CRDT- 2017/09/15 06:00
PHST- 2017/09/15 06:00 [entrez]
PHST- 2017/09/15 06:00 [pubmed]
PHST- 2017/09/25 06:00 [medline]
PHST- 2017/09/15 00:00 [pmc-release]
AID - 00005792-201709150-00057 [pii]
AID - MD-D-17-01453 [pii]
AID - 10.1097/MD.0000000000008066 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Sep;96(37):e8066. doi: 10.1097/MD.0000000000008066.