Cardiac resynchronization therapy non-responder to responder conversion rate in the MORE-CRT MPP trial
Christophe Leclercq1, Haran Burri2, Peter Paul Delnoy3
1Service de Cardiologie et Maladies Vasculaires, Université de Rennes I, CICIT 804, CHU Pontchaillou Rennes, 2, rue Henri le Guilloux 35033 Rennes Cédex 09, Rennes 35033, France.
Summary
MultiPoint™ Pacing (MPP) did not improve cardiac resynchronization therapy (CRT) response in non-responders after standard biventricular pacing (BiVP). Approximately 30% of non-responders showed improvement over six months, suggesting delayed CRT benefits.
Area of Science:
- Cardiology
- Medical Devices
- Clinical Trials
Background:
- Cardiac resynchronization therapy (CRT) is a treatment for heart failure.
- Some patients do not respond to standard biventricular pacing (BiVP).
- MultiPoint™ Pacing (MPP) is an alternative pacing strategy.
Purpose of the Study:
- To evaluate the effectiveness of MPP in CRT non-responders.
- To determine if MPP improves response rates compared to continued BiVP.
Main Methods:
- A randomized trial comparing MPP to BiVP in CRT non-responders.
- Echocardiography assessed left ventricular end-systolic volume reduction.
- Non-response defined as <15% reduction in LVESV after 6 months of BiVP.
Main Results:
- No significant difference in CRT response conversion rate between MPP (29.4%) and BiVP (30.4%) arms.
- Approximately 30% of non-responders became responders over an additional 6 months.
- No benefit observed in the subgroup with ≥30mm spacing between left ventricular pacing sites (MPP-AS).
Conclusions:
- CRT benefits may be delayed or slowly incremental in a proportion of patients.
- MPP does not enhance CRT response in patients initially non-responsive to BiVP.
- The overall CRT response rate might be underestimated in shorter-term studies.
