Contractility sensor-guided optimization of cardiac resynchronization therapy: results from the RESPOND-CRT trial

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Contractility sensor-guided optimization of cardiac resynchronization therapy: results from the RESPOND-CRT trial

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Title: Contractility sensor-guided optimization of cardiac resynchronization therapy: results from the RESPOND-CRT trial
Author: Brugada, Josep; Delnoy, Peter Paul; Brachmann, Johannes; Reynolds, Dwight; Padeletti, Luigi; Noelker, Georg; Kantipudi, Charan; Rubin Lopez, José Manuel; Dichtl, Wolfgang; Borri-Brunetto, Alberto; Verhees, Luc; Ritter, Philippe; Singh, Jagmeet P.

Note: Order does not necessarily reflect citation order of authors.

Citation: Brugada, J., P. P. Delnoy, J. Brachmann, D. Reynolds, L. Padeletti, G. Noelker, C. Kantipudi, et al. 2016. “Contractility sensor-guided optimization of cardiac resynchronization therapy: results from the RESPOND-CRT trial.” European Heart Journal 38 (10): 730-738. doi:10.1093/eurheartj/ehw526. http://dx.doi.org/10.1093/eurheartj/ehw526.
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Abstract: Aims Although cardiac resynchronization therapy (CRT) is effective in patients with systolic heart failure (HF) and a wide QRS interval, a substantial proportion of patients remain non-responsive. The SonR contractility sensor embedded in the right atrial lead enables individualized automatic optimization of the atrioventricular (AV) and interventricular (VV) timings. The RESPOND-CRT study investigated the safety and efficacy of the contractility sensor system in HF patients undergoing CRT. Methods and results RESPOND-CRT was a prospective, randomized, double-blinded, multicentre, non-inferiority trial. Patients were randomized (2:1, respectively) to receive weekly, automatic CRT optimization with SonR vs. an Echo-guided optimization of AV and VV timings. The primary efficacy endpoint was the rate of clinical responders (patients alive, without adjudicated HF-related events, with improvement in New York Heart Association class or quality of life), at 12 months. The study randomized 998 patients. Responder rates were 75.0% in the SonR arm and 70.4% in the Echo arm (mean difference, 4.6%; 95% CI, −1.4% to 10.6%; P < 0.001 for non-inferiority margin −10.0%) (Table 2). At an overall mean follow-up of 548 ± 190 days SonR was associated with a 35% risk reduction in HF hospitalization (hazard ratio, 0.65; 95% CI, 0.46–0.92; log-rank P = 0.01). Conclusion: Automatic AV and VV optimization using the contractility sensor was safe and as effective as Echo-guided AV and VV optimization in increasing response to CRT. ClinicalTrials.gov number NCT01534234
Published Version: doi:10.1093/eurheartj/ehw526
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353752/pdf/
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Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:32072049
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