PMID- 34379350
OWN - NLM
STAT- MEDLINE
DCOM- 20211020
LR  - 20220218
IS  - 1540-8167 (Electronic)
IS  - 1045-3873 (Linking)
VI  - 32
IP  - 9
DP  - 2021 Sep
TI  - Multipoint pacing for cardiac resynchronisation therapy in patients with heart 
      failure: A systematic review and meta-analysis.
PG  - 2577-2589
LID - 10.1111/jce.15199 [doi]
AB  - INTRODUCTION: Multipoint pacing (MPP) has been proposed as an effective way to 
      improve cardiac resynchronisation therapy (CRT) response. We performed a 
      systematic review and meta-analysis evaluating the efficacy of CRT delivered via 
      MPP compared to conventional CRT. METHODS: A literature search was performed from 
      inception to January 2021 for studies in Medline, Embase and Cochrane databases, 
      comparing MPP to conventional CRT with a minimum of 6 months follow-up. 
      Randomised and nonrandomised studies were assessed for relevant efficacy data 
      including echocardiographic (left ventricular end systolic volume [LVESV] and 
      ejection fraction) or functional changes (New York Heart Association [NYHA] 
      class/Clinical Composite Score). Subgroup analyses were performed by study design 
      and programming type. RESULTS: A total of 7 studies with a total of 1390 patients 
      were included in the final analysis. Overall, MPP demonstrated greater 
      echocardiographic improvement than conventional CRT in nonrandomised studies 
      (odds ratio [OR]: 5.33, 95% confidence interval [CI]: [3.05-9.33], p < .001), 
      however, was not significant in randomised studies (OR: 1.86, 95% CI: 
      [0.91-3.79], p = .086). There was no significant difference in LVESV reduction 
      >15% (OR: 1.96, 95% CI: [0.69-5.55], p = .20) or improvement by >/=1 NYHA class 
      (OR: 2.49, 95% CI: [0.74-8.42], p = .141) when comparing MPP to conventional CRT. 
      In a sub analysis, MPP programmed by widest anatomical separation (MPP-AS) 
      signalled greater efficacy, however, only 120 patients were included in this 
      analysis. CONCLUSION: Overall MPP was more efficacious in nonrandomised studies, 
      and not superior when assessed in randomised studies. There was considerable 
      heterogeneity in study design making overall interpretation of results 
      challenging. Widespread MPP programming in all CRT patients is currently not 
      justified. Further large, randomised studies with patient-specific programming 
      may clarify its effectiveness.
CI  - (c) 2021 The Authors. Journal of Cardiovascular Electrophysiology Published by 
      Wiley Periodicals LLC.
FAU - Mehta, Vishal S
AU  - Mehta VS
AUID- ORCID: 0000-0001-6140-068X
AD  - Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
AD  - Department of Imaging Sciences and Biomedical Engineering, King's College London, 
      London, UK.
FAU - Elliott, Mark K
AU  - Elliott MK
AUID- ORCID: 0000-0003-2805-3043
AD  - Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
AD  - Department of Imaging Sciences and Biomedical Engineering, King's College London, 
      London, UK.
FAU - Sidhu, Baldeep S
AU  - Sidhu BS
AUID- ORCID: 0000-0002-1999-7360
AD  - Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
AD  - Department of Imaging Sciences and Biomedical Engineering, King's College London, 
      London, UK.
FAU - Gould, Justin
AU  - Gould J
AUID- ORCID: 0000-0002-1897-5565
AD  - Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
AD  - Department of Imaging Sciences and Biomedical Engineering, King's College London, 
      London, UK.
FAU - Porter, Bradley
AU  - Porter B
AD  - Department of Imaging Sciences and Biomedical Engineering, King's College London, 
      London, UK.
FAU - Niederer, Steven
AU  - Niederer S
AD  - Department of Imaging Sciences and Biomedical Engineering, King's College London, 
      London, UK.
FAU - Rinaldi, Christopher A
AU  - Rinaldi CA
AUID- ORCID: 0000-0002-3930-1957
AD  - Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
AD  - Department of Imaging Sciences and Biomedical Engineering, King's College London, 
      London, UK.
LA  - eng
GR  - WT203148/Z/16/Z/WT_/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20210819
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
SB  - IM
CIN - J Cardiovasc Electrophysiol. 2021 Dec;32(12):3279. PMID: 34674345
CIN - J Cardiovasc Electrophysiol. 2021 Dec;32(12):3280-3281. PMID: 34698426
MH  - *Cardiac Resynchronization Therapy
MH  - *Heart Failure/diagnostic imaging/therapy
MH  - Humans
MH  - Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - MPP
OT  - cardiac resynchronisation therapy
OT  - efficacy
OT  - meta-analysis
OT  - multipoint pacing
OT  - systematic review
EDAT- 2021/08/12 06:00
MHDA- 2021/10/21 06:00
CRDT- 2021/08/11 12:34
PHST- 2021/07/02 00:00 [revised]
PHST- 2021/05/12 00:00 [received]
PHST- 2021/07/20 00:00 [accepted]
PHST- 2021/08/12 06:00 [pubmed]
PHST- 2021/10/21 06:00 [medline]
PHST- 2021/08/11 12:34 [entrez]
AID - 10.1111/jce.15199 [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2021 Sep;32(9):2577-2589. doi: 10.1111/jce.15199. 
      Epub 2021 Aug 19.