Safety and Efficacy of Multipoint Pacing in Cardiac Resynchronization Therapy: The MultiPoint Pacing Trial
Imran Niazi1, James Baker2, Raffaele Corbisiero3
1Aurora Cardiovascular Services, Aurora Sinai/Aurora St Luke's Medical Centers, Milwaukee, Wisconsin.
JACC. Clinical Electrophysiology
|May 16, 2018
Summary
MultiPoint Pacing (MPP) is a safe and effective treatment for heart failure, demonstrating non-inferiority to Bi-ventricular pacing. This advanced pacing strategy significantly improved patient response rates in the MultiPoint Pacing IDE Study.
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Management
Background:
- Cardiac resynchronization therapy (CRT) nonresponse is a significant challenge in heart failure management.
- Stimulating multiple left ventricular sites may offer a solution to improve CRT efficacy.
Purpose of the Study:
- To assess the safety and efficacy of MultiPoint Pacing (MPP) using a quadripolar lead for pacing two left ventricular sites.
- To compare the efficacy of MPP against standard Bi-ventricular (Bi-V) pacing in patients indicated for CRT-D devices.
Main Methods:
- The MultiPoint Pacing IDE Study enrolled patients indicated for CRT-D systems.
- Patients initially received Bi-V pacing, with randomization to Bi-V or MPP at 3 months.
- Clinical response was assessed at 3 and 9 months post-randomization, with a primary safety endpoint of system-related complications.
Main Results:
- The CRT-D system implant success rate was 97%, with the primary safety endpoint met (93.2% freedom from complications).
- MPP demonstrated non-inferiority to Bi-V pacing regarding nonresponder rates.
- Pacing from anatomically distant poles within the MPP arm (MPP-AS) showed significantly higher response rates compared to other MPP settings (MPP-Other), with 87% responders at 9 months.
Conclusions:
- MultiPoint Pacing (MPP) is a safe and effective strategy for heart failure patients requiring CRT-D.
- The study confirmed that MPP response is non-inferior to Bi-V pacing when using a quadripolar left ventricular lead.
- MPP, particularly with anatomically distant pole stimulation, offers improved response rates in heart failure patients.
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