19-06: Clinical Outcomes at One Year Follow UP in cardiac resynchronization therapy with Acute Optimization of Left Ventricular Pacing Site and Multipoint Pacing

Abstract

Introduction: The clinical response to cardiac resynchronization therapy (CRT) is variable. The optimization of the left ventricle (LV) pacing site increases the number of responder to CRT. The Multipoint (MPP) pacing could further increase hemodynamic response to and clinical outcome of CRT. The purpose of our study was to test the hypothesis that pts optimized at implant and treated with MPP experience superior long-term clinical outcomes than conventional CRT pts. Methods: 110 HF pts treated for 1 year with either conventional CRT(STD, N = 54), CRT with hemodynamic and electrical optimized LV pacing site (OPT, N = 36), and with optimized LV pacing site + MPP (OPT-MPP, N = 20) were evaluated to determine CRT response relative to baseline. Responders were classified in terms of 1-year reduction in end-systolic volume index≥ 15%, reduction in NYHA class ≥ 1, and PACKER score variation (NYHA response with no HF-related hospitalization or death). Results: In terms of ESVi, 55.6% of STD, 72.2% of OPT, and 90.0% of OPT-MPP pts were responders. In terms of NYHA, 66.7% of STD, 77.8% of OPT, and 95.0% of OPT-MPP pts responded, with more MPP pts experiencing a NYHA downgrade of 2 classes or beyond. Likewise, 59.3.0% of STD, 66.7% of OPT, and 90.0% of OPT-MPP pts exhibited a 1-year PACKER response.