In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study.

M Sterliński; A Sokal; R Lenarczyk; Heuverswyn F Van; CA Rinaldi; M Vanderheyden; V Khalameizer; D Francis; J Heynens; B Stegemann; R Cornelussen

doi:10.1371/journal.pone.0154024

In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study.

M Sterliński, A Sokal, R Lenarczyk, Heuverswyn F Van, CA Rinaldi, M Vanderheyden, V Khalameizer, D Francis, J Heynens, B Stegemann, R Cornelussen

Aston Medical School

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction
Recent efforts to increase CRT response by multiSPOT pacing (MSP) from multiple bipols on the same left ventricular lead are still inconclusive.

Aim
The Left Ventricular (LV) MultiSPOTpacing for CRT (iSPOT) study compared the acute hemodynamic response of MSP pacing by using 3 electrodes on a quadripolar lead compared with conventional biventricular pacing (BiV).

Methods
Patients with left bundle branch block (LBBB) underwent an acute hemodynamic study to determine the %change in LV+dP/dtmax from baseline atrial pacing compared to the following configurations: BiV pacing with the LV lead in a one of lateral veins, while pacing from the distal, mid, or proximal electrode and all 3 electrodes together (i.e. MSP). All measurements were repeated 4 times at 5 different atrioventricular delays. We also measured QRS-width and individual Q-LV durations.

Results
Protocol was completed in 24 patients, all with LBBB (QRS width 171±20 ms) and 58% ischemic aetiology. The percentage change in LV+dP/dtmax for MSP pacing was 31.0±3.3% (Mean±SE), which was not significantly superior to any BiV pacing configuration: 28.9±3.2% (LV-distal), 28.3±2.7% (LV-mid), and 29.5±3.0% (LV-prox), respectively. Correlation between LV+dP/dtmax and either QRS-width or Q-LV ratio was poor.

Conclusions
In patients with LBBB MultiSPOT LV pacing demonstrated comparable improvement in contractility to best conventional BiV pacing. Optimization of atrioventricular delay is important for the best performance for both BiV and MultiSPOT pacing configurations.

Trial Registration
ClinicalTrials.gov NTC01883141

Original language	English
Article number	e0154024
Journal	PLoS ONE
Volume	11
Issue number	4
DOIs	https://doi.org/10.1371/journal.pone.0154024
Publication status	Published - 28 Apr 2016

Bibliographical note

© 2016 Sterliński et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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10.1371/journal.pone.0154024Licence: CC BY 3.0

In Heart Failure Patients with Left Bundle Branch Block Single Lead
© 2016 Sterliński et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Final published version, 1.23 MBLicence: CC BY 3.0

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Sterliński, M., Sokal, A., Lenarczyk, R., Van, H. F., Rinaldi, CA., Vanderheyden, M., Khalameizer, V., Francis, D., Heynens, J., Stegemann, B., & Cornelussen, R. (2016). In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study. PLoS ONE, 11(4), Article e0154024. https://doi.org/10.1371/journal.pone.0154024

@article{05e75d7e41a64d29a4e32b51224dcfa8,

title = "In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study.",

abstract = "IntroductionRecent efforts to increase CRT response by multiSPOT pacing (MSP) from multiple bipols on the same left ventricular lead are still inconclusive.AimThe Left Ventricular (LV) MultiSPOTpacing for CRT (iSPOT) study compared the acute hemodynamic response of MSP pacing by using 3 electrodes on a quadripolar lead compared with conventional biventricular pacing (BiV).MethodsPatients with left bundle branch block (LBBB) underwent an acute hemodynamic study to determine the %change in LV+dP/dtmax from baseline atrial pacing compared to the following configurations: BiV pacing with the LV lead in a one of lateral veins, while pacing from the distal, mid, or proximal electrode and all 3 electrodes together (i.e. MSP). All measurements were repeated 4 times at 5 different atrioventricular delays. We also measured QRS-width and individual Q-LV durations.ResultsProtocol was completed in 24 patients, all with LBBB (QRS width 171±20 ms) and 58% ischemic aetiology. The percentage change in LV+dP/dtmax for MSP pacing was 31.0±3.3% (Mean±SE), which was not significantly superior to any BiV pacing configuration: 28.9±3.2% (LV-distal), 28.3±2.7% (LV-mid), and 29.5±3.0% (LV-prox), respectively. Correlation between LV+dP/dtmax and either QRS-width or Q-LV ratio was poor.ConclusionsIn patients with LBBB MultiSPOT LV pacing demonstrated comparable improvement in contractility to best conventional BiV pacing. Optimization of atrioventricular delay is important for the best performance for both BiV and MultiSPOT pacing configurations.Trial RegistrationClinicalTrials.gov NTC01883141",

author = "M Sterli{\'n}ski and A Sokal and R Lenarczyk and Van, {Heuverswyn F} and CA Rinaldi and M Vanderheyden and V Khalameizer and D Francis and J Heynens and B Stegemann and R Cornelussen",

note = "{\textcopyright} 2016 Sterli{\'n}ski et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2016",

month = apr,

day = "28",

doi = "10.1371/journal.pone.0154024",

language = "English",

volume = "11",

journal = "PLoS ONE",

issn = "1932-6203",

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Sterliński, M, Sokal, A, Lenarczyk, R, Van, HF, Rinaldi, CA, Vanderheyden, M, Khalameizer, V, Francis, D, Heynens, J, Stegemann, B & Cornelussen, R 2016, 'In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study.', PLoS ONE, vol. 11, no. 4, e0154024. https://doi.org/10.1371/journal.pone.0154024

In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study. / Sterliński, M; Sokal, A; Lenarczyk, R et al.
In: PLoS ONE, Vol. 11, No. 4, e0154024, 28.04.2016.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study.

AU - Sterliński, M

AU - Sokal, A

AU - Lenarczyk, R

AU - Van, Heuverswyn F

AU - Rinaldi, CA

AU - Vanderheyden, M

AU - Khalameizer, V

AU - Francis, D

AU - Heynens, J

AU - Stegemann, B

AU - Cornelussen, R

N1 - © 2016 Sterliński et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2016/4/28

Y1 - 2016/4/28

N2 - IntroductionRecent efforts to increase CRT response by multiSPOT pacing (MSP) from multiple bipols on the same left ventricular lead are still inconclusive.AimThe Left Ventricular (LV) MultiSPOTpacing for CRT (iSPOT) study compared the acute hemodynamic response of MSP pacing by using 3 electrodes on a quadripolar lead compared with conventional biventricular pacing (BiV).MethodsPatients with left bundle branch block (LBBB) underwent an acute hemodynamic study to determine the %change in LV+dP/dtmax from baseline atrial pacing compared to the following configurations: BiV pacing with the LV lead in a one of lateral veins, while pacing from the distal, mid, or proximal electrode and all 3 electrodes together (i.e. MSP). All measurements were repeated 4 times at 5 different atrioventricular delays. We also measured QRS-width and individual Q-LV durations.ResultsProtocol was completed in 24 patients, all with LBBB (QRS width 171±20 ms) and 58% ischemic aetiology. The percentage change in LV+dP/dtmax for MSP pacing was 31.0±3.3% (Mean±SE), which was not significantly superior to any BiV pacing configuration: 28.9±3.2% (LV-distal), 28.3±2.7% (LV-mid), and 29.5±3.0% (LV-prox), respectively. Correlation between LV+dP/dtmax and either QRS-width or Q-LV ratio was poor.ConclusionsIn patients with LBBB MultiSPOT LV pacing demonstrated comparable improvement in contractility to best conventional BiV pacing. Optimization of atrioventricular delay is important for the best performance for both BiV and MultiSPOT pacing configurations.Trial RegistrationClinicalTrials.gov NTC01883141

AB - IntroductionRecent efforts to increase CRT response by multiSPOT pacing (MSP) from multiple bipols on the same left ventricular lead are still inconclusive.AimThe Left Ventricular (LV) MultiSPOTpacing for CRT (iSPOT) study compared the acute hemodynamic response of MSP pacing by using 3 electrodes on a quadripolar lead compared with conventional biventricular pacing (BiV).MethodsPatients with left bundle branch block (LBBB) underwent an acute hemodynamic study to determine the %change in LV+dP/dtmax from baseline atrial pacing compared to the following configurations: BiV pacing with the LV lead in a one of lateral veins, while pacing from the distal, mid, or proximal electrode and all 3 electrodes together (i.e. MSP). All measurements were repeated 4 times at 5 different atrioventricular delays. We also measured QRS-width and individual Q-LV durations.ResultsProtocol was completed in 24 patients, all with LBBB (QRS width 171±20 ms) and 58% ischemic aetiology. The percentage change in LV+dP/dtmax for MSP pacing was 31.0±3.3% (Mean±SE), which was not significantly superior to any BiV pacing configuration: 28.9±3.2% (LV-distal), 28.3±2.7% (LV-mid), and 29.5±3.0% (LV-prox), respectively. Correlation between LV+dP/dtmax and either QRS-width or Q-LV ratio was poor.ConclusionsIn patients with LBBB MultiSPOT LV pacing demonstrated comparable improvement in contractility to best conventional BiV pacing. Optimization of atrioventricular delay is important for the best performance for both BiV and MultiSPOT pacing configurations.Trial RegistrationClinicalTrials.gov NTC01883141

UR - http://europepmc.org/abstract/med/27124724

UR - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154024

U2 - 10.1371/journal.pone.0154024

DO - 10.1371/journal.pone.0154024

M3 - Article

C2 - 27124724

SN - 1932-6203

VL - 11

JO - PLoS ONE

JF - PLoS ONE

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Sterliński M, Sokal A, Lenarczyk R, Van HF, Rinaldi CA, Vanderheyden M et al. In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study. PLoS ONE. 2016 Apr 28;11(4):e0154024. doi: 10.1371/journal.pone.0154024

In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study.

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