PMID- 34255376
OWN - NLM
STAT- MEDLINE
DCOM- 20220131
LR  - 20220131
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 44
IP  - 9
DP  - 2021 Sep
TI  - Imaging-guided cardiac resynchronization therapy: A meta-analysis of randomized 
      controlled trials.
PG  - 1570-1576
LID - 10.1111/pace.14316 [doi]
AB  - BACKGROUND: Among patients with heart failure and left ventricular (LV) 
      dysfunction despite guideline directed medical therapy, cardiac resynchronization 
      (CRT) is an effective technology to reverse LV remodeling. Given that a large 
      portion of patients are non-responders, alternatives to traditional LV-lead 
      placement have been explored. A promising alternative is image targeted placement 
      of an LV-lead to latest mechanically activated segment without scar. METHODS: 
      Electronic database search for randomized controlled trials (RCTs) that evaluated 
      the imaging-guided LV-lead placement on clinical, echocardiographic, and 
      functional outcomes. The primary outcome was a composite of mortality and heart 
      failure hospitalization. The secondary outcomes included CRT responders, New York 
      Heart Association (NYHA), 6-minute walk test, Minnesota Living with Heart Failure 
      Questionnaire (MLHFQ), and ejection fraction (EF) changes. RESULTS: Analysis 
      included 4 RCTs of 691 patients with an average follow-up of 2 years (age 69.5 +/- 
      10.3 years, 76% males, 54% ischemic cardiomyopathy, 81% with NYHA classes III/IV, 
      and EF of 24.4% +/- 8). The most common site for LV-lead paced segment was the 
      anterolateral segment (45%) and at mid-LV (49%). Compared with the control, 
      imaging-guided LV-lead placement was associated with a significant reduction of 
      the primary outcome (hazard ratio [HR] = 0.60; 95% CI = 0.40-0.88; p = .01), 
      higher CRT responders (odd ratio [OR] = 2.10; p < .01), more NYHA improvements by 
      >/=1 (OR = 1.89; p = .01), increased 6MWT (mean difference [MD] = 25.78 feet; 
      p < .01), and lower MLHFQ (MD = -4.04; p = .04), without significant differences 
      in the LVEF (p = .08). CONCLUSIONS: In patients undergoing CRT, imaging-guided 
      LV-lead placement was associated with improved clinical, echocardiographic, and 
      functional status.
CI  - (c) 2021 Wiley Periodicals LLC.
FAU - Kheiri, Babikir
AU  - Kheiri B
AUID- ORCID: 0000-0003-1747-2859
AD  - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, 
      Oregon, USA.
FAU - Przybylowicz, Ryle
AU  - Przybylowicz R
AUID- ORCID: 0000-0002-1140-5164
AD  - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, 
      Oregon, USA.
FAU - Simpson, Timothy F
AU  - Simpson TF
AD  - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, 
      Oregon, USA.
FAU - Merrill, Miranda
AU  - Merrill M
AD  - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, 
      Oregon, USA.
FAU - Osman, Mohammed
AU  - Osman M
AUID- ORCID: 0000-0001-5097-5568
AD  - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, 
      Oregon, USA.
AD  - Division of Cardiology, West Virginia University School of Medicine, Morgantown, 
      West Virginia, USA.
FAU - Dalouk, Khidir
AU  - Dalouk K
AD  - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, 
      Oregon, USA.
FAU - Rahmouni, Hind
AU  - Rahmouni H
AD  - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, 
      Oregon, USA.
FAU - Stecker, Eric
AU  - Stecker E
AD  - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, 
      Oregon, USA.
FAU - Nazer, Babak
AU  - Nazer B
AUID- ORCID: 0000-0002-4078-9064
AD  - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, 
      Oregon, USA.
FAU - Henrikson, Charles A
AU  - Henrikson CA
AD  - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, 
      Oregon, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20210721
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Humans
MH  - *Magnetic Resonance Imaging, Interventional
MH  - Prosthesis Implantation/*methods
MH  - *Radiography, Interventional
MH  - Randomized Controlled Trials as Topic
MH  - *Ultrasonography, Interventional
OTO - NOTNLM
OT  - cardiac CT
OT  - cardiac MRI
OT  - cardiac resynchronization therapy
OT  - cardiomyopathy
OT  - echocardiography
OT  - heart failure
OT  - left ventricular lead position
OT  - multimodality imaging
EDAT- 2021/07/14 06:00
MHDA- 2022/02/01 06:00
CRDT- 2021/07/13 12:33
PHST- 2021/06/07 00:00 [revised]
PHST- 2021/03/09 00:00 [received]
PHST- 2021/07/11 00:00 [accepted]
PHST- 2021/07/14 06:00 [pubmed]
PHST- 2022/02/01 06:00 [medline]
PHST- 2021/07/13 12:33 [entrez]
AID - 10.1111/pace.14316 [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2021 Sep;44(9):1570-1576. doi: 10.1111/pace.14316. 
      Epub 2021 Jul 21.