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Targeted left ventricular lead positioning to the site of latest activation in cardiac resynchronization therapy: a systematic review and meta-analysis
DB. Fyenbo, HL. Bjerre, MHJP. Frausing, C. Stephansen, A. Sommer, R. Borgquist, Z. Bakos, M. Glikson, A. Milman, R. Beinart, R. Kockova, K. Sedlacek, D. Wichterle, S. Saba, S. Jain, A. Shalaby, MB. Kronborg, JC. Nielsen
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu metaanalýza, systematický přehled, časopisecké články
Grantová podpora
Aarhus University
R140-A9482-B2407
Danish Heart Foundation
R64-A3194-B1667
Health Research Foundation of Central Denmark Region
Gangstedfonden
PhD2021011-HF
Danish Cardiovascular Academy
PubMed Central od 2008
Open Access Digital Library od 1999-01-01
Medline Complete (EBSCOhost) od 1999-01-01
Oxford Journals Open Access Collection od 1999-01-01
Odkazy
PubMed
37695316
DOI
10.1093/europace/euad267
Knihovny.cz E-zdroje
- MeSH
- echokardiografie MeSH
- hospitalizace MeSH
- lidé MeSH
- srdeční komory diagnostické zobrazování MeSH
- srdeční resynchronizační terapie * škodlivé účinky MeSH
- srdeční selhání * diagnóza terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- systematický přehled MeSH
AIMS: Several studies have evaluated the use of electrically- or imaging-guided left ventricular (LV) lead placement in cardiac resynchronization therapy (CRT) recipients. We aimed to assess evidence for a guided strategy that targets LV lead position to the site of latest LV activation. METHODS AND RESULTS: A systematic review and meta-analysis was performed for randomized controlled trials (RCTs) until March 2023 that evaluated electrically- or imaging-guided LV lead positioning on clinical and echocardiographic outcomes. The primary endpoint was a composite of all-cause mortality and heart failure hospitalization, and secondary endpoints were quality of life, 6-min walk test (6MWT), QRS duration, LV end-systolic volume, and LV ejection fraction. We included eight RCTs that comprised 1323 patients. Six RCTs compared guided strategy (n = 638) to routine (n = 468), and two RCTs compared different guiding strategies head-to-head: electrically- (n = 111) vs. imaging-guided (n = 106). Compared to routine, a guided strategy did not significantly reduce the risk of the primary endpoint after 12-24 (RR 0.83, 95% CI 0.52-1.33) months. A guided strategy was associated with slight improvement in 6MWT distance after 6 months of follow-up of absolute 18 (95% CI 6-30) m between groups, but not in remaining secondary endpoints. None of the secondary endpoints differed between the guided strategies. CONCLUSION: In this study, a CRT implantation strategy that targets the latest LV activation did not improve survival or reduce heart failure hospitalizations.
Arrhythmia Section Skaane University Hospital Lund Sweden
Department of Cardiac Surgery Na Homolce Hospital Prague Czech Republic
Department of Cardiology Aalborg University Hospital Aalborg Denmark
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Cardiology Kristianstad Hospital Kristianstad Sweden
Diagnostic Center Silkeborg Regional Hospital Falkevej 1A 8600 Silkeborg Denmark
Faculty of Medicine Charles University Hradec Králové Czech Republic
Faculty of Medicine Hebrew University Jerusalem Israel
Jesselson Integrated Heart Center Shaare Zedek Medical Center Jerusalem Israel
Leviev Heart Institute The Chaim Sheba Medical Center Tel Hashomer Israel
Sackler School of Medicine Tel Aviv University Tel Aviv Israel
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