Efficacy on resynchronization and longitudinal contractile function comparing His-bundle pacing with conventional biventricular pacing: a substudy to the His-alternative study
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Efficacy on resynchronization and longitudinal contractile function comparing His-bundle pacing with conventional biventricular pacing : a substudy to the His-alternative study. / Højgaard, E. V.; Philbert, B. T.; Linde, J. J.; Winsløw, U. C.; Svendsen, J. H.; Vinther, M.; Risum, N.
I: European Heart Journal Cardiovascular Imaging, Bind 25, Nr. 1, 2024, s. 66-74.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Efficacy on resynchronization and longitudinal contractile function comparing His-bundle pacing with conventional biventricular pacing
T2 - a substudy to the His-alternative study
AU - Højgaard, E. V.
AU - Philbert, B. T.
AU - Linde, J. J.
AU - Winsløw, U. C.
AU - Svendsen, J. H.
AU - Vinther, M.
AU - Risum, N.
N1 - Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved.
PY - 2024
Y1 - 2024
N2 - Aims His-bundle pacing has emerged as a novel method to deliver cardiac resynchronization therapy (CRT). However, there are no data comparing conventional biventricular (BiV)-CRT with His-CRT with regard to effects on mechanical dyssynchrony and longitudinal contractile function. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Methods Patients with symptomatic heart failure, left ventricular ejection fraction ≤ 35%, and left bundle branch block (LBBB) by strict and results ECG criteria were randomized 1:1 to His-CRT or BiV-CRT. Two-dimensional strain echocardiography was performed prior to CRT implantation and at 6 months after implantation. Differences in changes in mechanical dyssynchrony (standard deviation of time-to-peak in 12 midventricular and basal segments) and regional longitudinal strain in the six left ventricular walls were compared between the BiV-CRT and His-CRT groups. In the on-treatment analysis, 31 received BiV-CRT and 19 His-CRT. In both groups, mechanical dyssynchrony was significantly reduced after 6 months [BiV group from 120 ms (±45) to 63 ms (±22), P < 0.001, and His group from 116 ms (±54) to 49 ms (±11), P < 0.001] but no significant differences in changes could be demonstrated between groups [−9.0 ms (−36; 18), P = 0.50]. Global longitudinal strain (GLS) improved in both groups [BiV group from −9.1% (±2.7) to −10.7% (±2.6), P = 0.02, and His group from −8.6% (±2.1) to −11.1% (±2.0), P < 0.001], but no significant differences in changes could be demonstrated from baseline to follow-up [−0.9% (−2.4; −0.6), P = 0.25] between groups. There were no regional differences between groups. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conclusion In heart failure, patients with LBBB, BiV-CRT, and His-CRT have comparable effects with regard to improvements in mechanical dyssynchrony and longitudinal contractile function.
AB - Aims His-bundle pacing has emerged as a novel method to deliver cardiac resynchronization therapy (CRT). However, there are no data comparing conventional biventricular (BiV)-CRT with His-CRT with regard to effects on mechanical dyssynchrony and longitudinal contractile function. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Methods Patients with symptomatic heart failure, left ventricular ejection fraction ≤ 35%, and left bundle branch block (LBBB) by strict and results ECG criteria were randomized 1:1 to His-CRT or BiV-CRT. Two-dimensional strain echocardiography was performed prior to CRT implantation and at 6 months after implantation. Differences in changes in mechanical dyssynchrony (standard deviation of time-to-peak in 12 midventricular and basal segments) and regional longitudinal strain in the six left ventricular walls were compared between the BiV-CRT and His-CRT groups. In the on-treatment analysis, 31 received BiV-CRT and 19 His-CRT. In both groups, mechanical dyssynchrony was significantly reduced after 6 months [BiV group from 120 ms (±45) to 63 ms (±22), P < 0.001, and His group from 116 ms (±54) to 49 ms (±11), P < 0.001] but no significant differences in changes could be demonstrated between groups [−9.0 ms (−36; 18), P = 0.50]. Global longitudinal strain (GLS) improved in both groups [BiV group from −9.1% (±2.7) to −10.7% (±2.6), P = 0.02, and His group from −8.6% (±2.1) to −11.1% (±2.0), P < 0.001], but no significant differences in changes could be demonstrated from baseline to follow-up [−0.9% (−2.4; −0.6), P = 0.25] between groups. There were no regional differences between groups. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conclusion In heart failure, patients with LBBB, BiV-CRT, and His-CRT have comparable effects with regard to improvements in mechanical dyssynchrony and longitudinal contractile function.
KW - 2D speckle tracking
KW - biventricular pacing
KW - cardiac resynchronization therapy
KW - heart failure
KW - His-bundle pacing
KW - left bundle branch block
U2 - 10.1093/ehjci/jead181
DO - 10.1093/ehjci/jead181
M3 - Journal article
C2 - 37490036
AN - SCOPUS:85181178052
VL - 25
SP - 66
EP - 74
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
SN - 2047-2404
IS - 1
ER -
ID: 381722370