Arrhythmia and Electrophysiology Unit, Cardiology Department*, Santa Maria Della Misericordia Hospital, Rovigo, Italy. Department of Molecular Medicine, University of Padua, Italy. Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
Introduction: Response to cardiac resynchronization therapy (CRT) is still a clinical challenge. Pacing from multiple site of the LV has showed promising results in preliminary acute analysis. The aim of this study is to evaluate the long term clinical response of multipoint pacing (MPP) from a single LV vein, by means of a quadripolar lead.
Methods: Twenty patients candidates to CRT (16 male, mean age 67±12 years) were implanted with a LV quadripolar lead and a device with Multipoint pacing (MPP) capability. The LV lead site was optimized at implant by means of a systematical screening of LV electrical delay and LV dP/dtmax in all available tributary veins of the coronary sinus. The 1-year clinical response (in term of remodeling and functional status) of MPP pts was compared with a group of 54 pts implanted with the conventional standard CRT procedure in the previous years.
Results: In MPP group, at 12 months follow up, 18 pts (90%) reported ?LVESVi?15%, 19 (95%) improved ? 1 NYHA class and 18 (90%) responded as Packer HF index. Comparison with conventional group (unvaried analysis) is reported in figure. At multivariate analysis, the comparison between group resulted in better response in MPP group: ?LVESVi?15% with OR 9.53 (95% CI 1.84 to 49.27; p=0.007), ? 1 NYHA class with OR 9.59 (95% CI 1.06 to 86.69; p=0.044), Packer HF index with OR 7.95 (95% CI 0.88
Conclusions: In our experience pts treated with Multipoint pacing showed better clinical response at 1 year follow up compared to conventional CRT pts.