PMID- 34342026 OWN - NLM STAT- MEDLINE DCOM- 20211015 LR - 20211015 IS - 1932-8737 (Electronic) IS - 0160-9289 (Print) IS - 0160-9289 (Linking) VI - 44 IP - 9 DP - 2021 Sep TI - Left ventricular-only fusion pacing versus cardiac resynchronization therapy in heart failure patients: A randomized controlled trial. PG - 1225-1232 LID - 10.1002/clc.23616 [doi] AB - BACKGROUND: It is unclear whether clinical benefits of cardiac resynchronization can be achieved by pacing only the left ventricle. HYPOTHESIS: We aimed to compare the effect of a novel adaptive left ventricular-only fusion pacing (LVP) on ventricular function with conventional biventricular pacing (BVP) in cardiac resynchronization therapy (CRT) indicated patients. METHODS: This prospective, randomized, multicenter study enrolled CRT-indicated patients with PR interval 45%, and LV end-systolic volume (LVESV) decrease >15%, and New York Heart Association (NYHA) class improved by at least one level. RESULTS: Sixty-three patients were enrolled in the study (LVP = 34 vs. BVP = 29). At 6-month follow-up, significant improvements in LVEF, LVESV, and NYHA class were observed in both groups. The CRT super response rate was significantly higher in patients with high-percentage adaptive LV-only pacing in LVP group (68.4%) than in BVP group (36.4%, p = .04). CONCLUSIONS: Adaptive LV-only pacing was comparable to BVP in improving cardiac function and clinical condition in CRT-indicated patients. This finding raises the possibility that an adaptive LVP algorithm with appropriate right ventricular sensing to fuse with intrinsic right ventricular activation in a two-lead (right atrium and left ventricle) device may provide clinical benefit in a subset of CRT patients with intact atrioventricular conduction. CI - (c) 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC. FAU - Su, Yangang AU - Su Y AD - Department of Cardiology, Zhongshan Hospital of Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China. FAU - Hua, Wei AU - Hua W AD - 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 - Shen, Farong AU - Shen F AD - Department of Cardiology, Zhejiang Greentown Cardiovascular Hospital, Hangzhou, China. FAU - Zou, Jiangang AU - Zou J AD - Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. FAU - Tang, Baopeng AU - Tang B AD - Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China. FAU - Chen, Keping AU - Chen K AD - 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 - Liang, Yixiu AU - Liang Y AD - Department of Cardiology, Zhongshan Hospital of Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China. FAU - He, Lang AU - He L AD - Department of Cardiology, Zhejiang Greentown Cardiovascular Hospital, Hangzhou, China. FAU - Zhou, Xiaohong AU - Zhou X AD - Cardiac Rhythm Management, Medtronic plc, Mounds View, Minnesota, USA. FAU - Zhang, Xue AU - Zhang X AD - Cardiac Rhythm Management, Medtronic Technology Center, Medtronic (Shanghai) Ltd, Shanghai, China. FAU - Lu, Hongyang AU - Lu H AD - Cardiac Rhythm Management, Medtronic Technology Center, Medtronic (Shanghai) Ltd, Shanghai, China. FAU - Zhang, Shu AU - Zhang S AUID- ORCID: 0000-0003-3127-9086 AD - 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. LA - eng GR - Medtronic/ PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20210803 PL - United States TA - Clin Cardiol JT - Clinical cardiology JID - 7903272 SB - IM MH - *Cardiac Resynchronization Therapy MH - *Heart Failure/diagnosis/therapy MH - Heart Ventricles/diagnostic imaging MH - Humans MH - Prospective Studies MH - Stroke Volume MH - Treatment Outcome MH - Ventricular Function, Left PMC - PMC8427977 OTO - NOTNLM OT - AdaptivCRT OT - cardiac resynchronization therapy OT - left ventricular fusion pacing COIS- Yangang Su, Wei Hua, Farong Shen, Jiangang Zou, Baopeng Tang, and Keping Chen have received research grants from Medtronic. Shu Zhang has received consulting fees from Boston Scientific, Medtronic, St. Jude Medical, and Biotronik. Xiaohong Zhou, Xue Zhang and Hongyang Lu are employees of Medtronic. Yixiu Liang and Lang He have no competing interest to disclose. EDAT- 2021/08/04 06:00 MHDA- 2021/10/16 06:00 PMCR- 2021/08/03 CRDT- 2021/08/03 06:51 PHST- 2021/04/14 00:00 [revised] PHST- 2021/02/26 00:00 [received] PHST- 2021/04/20 00:00 [accepted] PHST- 2021/08/04 06:00 [pubmed] PHST- 2021/10/16 06:00 [medline] PHST- 2021/08/03 06:51 [entrez] PHST- 2021/08/03 00:00 [pmc-release] AID - CLC23616 [pii] AID - 10.1002/clc.23616 [doi] PST - ppublish SO - Clin Cardiol. 2021 Sep;44(9):1225-1232. doi: 10.1002/clc.23616. Epub 2021 Aug 3.