P578Multipoint pacing in cardiac resynchronization therapy - how to improve remodeling criteria and its impact in quality of life

• DOI: 10.1093/europace/euaa162.085
• Publication Date: 2020-06-18T09:03:14Z
• Authors: A Nunes Ferreira; P S Antonio; I Aguiar-Ricardo; T Rodrigues; N Cunha; R P Santos; J Rigueira; A Bernardes; I Santos; S Goncalves; F J Pinto; J De Sousa; P Marques
• Keywords: Dilated Cardiomyopathy; Ischemic Cardiomyopathy

Abstract Background Despite the reduction in mortality and hospitalization rates, resynchronization therapy still has 30-40% of non-responders. Several studies are ongoing to evaluate if novel programming techniques such as multipoint pacing (MPP) increase conversion rate non-responder responder CRT. However, there is lack information about super-responders impact quality life MPP. Purpose To MPP its patients. Methods Randomized clinical trial non-AF patients with indication for CRT who implanted Quartet™ quadripolar left ventricle (LV) lead. After implant, CRTs were programmed on biventricular according latest activated area 6 months. a 6-month follow-up, randomized 1:1 fashion ON or OFF. was two widest spaced LV electrodes LV1-LV2 LV2-RV delay 5ms. Patients followed-up 12 months evaluation NTproBNP, echocardiographic remodeling criteria (LV end systolic volume (ESV) ejection fraction), (QoL) evaluated by EQ-5D, Minnesota Living Heart Failure (MLWHF) questionnaire 6-minute walk test (6MWT). Results 76 included this trial, 62 completed 12-month follow-up (average age 67.2 ± 10.2 years old, 32.3% female gender, dilated cardiomyopathy 77.4%). Among these patients, 24 ON, 28 Six died 4 lost follow-up. Baseline characteristics similar between groups (p = NS). At months, overall response (reduction ESV≥15%) 75%. twelve had super-response ESV≥30%) higher than OFF (75% vs 39.3%, p 0.01). Between 6-12 assigned ESV (93.4 52.3mL 82.1 40.5mL, 0.04) an improvement LVEF (38.3 9.8% 45.1 11.1%, < 0.01) compared (92.2 47.3mL 95.4 47.5mL, NS; 37.1 12.0% 40.2 9.2%, Additionally, QoL improved during follow up (EQ-5D 78.3% 86.3%, 0.01; MLWHF 12.1 6.6, 0.03, 6MWT 316m 239m, NTproBNP 1608 2450pg/mL 775 914pg/mL, NS) unchanged (76.6% 74.2%; 12.7 12.7; 338m 299m, 1112 1442pg/mL 1383 2118pg/mL, all Conclusion In our population, when OFF, life. These results may be consequence from more favorable reverse due MPP, volume. Figure.