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    Standard care vs. TRIVEntricular pacing in Heart Failure (STRIVE HF): a prospective multicentre randomized controlled trial of triventricular pacing vs. conventional biventricular pacing in patients with heart failure and intermediate QRS left bundle branch block

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    Author
    Nicolson, Will
    Keyword
    cardiac resynchronization therapy
    multi-lead left ventricular pacing
    multi-site pacing
    triventricular pacing
    Date
    2021
    
    Metadata
    Show full item record
    Publisher's URL
    https://academic.oup.com/europace/advance-article/doi/10.1093/europace/euab267/6433090?login=true
    Abstract
    Aims: To determine whether triventricular (TriV) pacing is feasible and improves CRT response compared to conventional biventricular (BiV) pacing in patients with left bundle branch block (LBBB) and intermediate QRS prolongation (120-150 ms). Methods and results: Between October 2015 and November 2019, 99 patients were recruited from 11 UK centres. Ninety-five patients were randomized 1:1 to receive TriV or BiV pacing systems. The primary endpoint was feasibility of TriV pacing. Secondary endpoints assessed symptomatic and remodelling response to CRT. Baseline characteristics were balanced between groups. In the TriV group, 43/46 (93.5%) patients underwent successful implantation vs. 47/49 (95.9%) in the BiV group. Feasibility of maintaining CRT at 6 months was similar in the TriV vs. BiV group (90.0% vs. 97.7%, P = 0.191). All-cause mortality was similar between TriV vs. BiV groups (4.3% vs. 8.2%, P = 0.678). There were no significant differences in echocardiographic LV volumes or clinical composite scores from baseline to 6-month follow-up between groups. Conclusion: Implantation of two LV leads to deliver and maintain TriV pacing at 6 months is feasible without significant complications in the majority of patients. There was no evidence that TriV pacing improves CRT response or provides additional clinical benefit to patients with LBBB and intermediate QRS prolongation and cannot be recommended in this patient group. Clinical trial registration number: Clinicaltrials.gov: NCT02529410.
    Citation
    Gould, J., Claridge, S., Jackson, T., Sieniewicz, B. J., Sidhu, B. S., Porter, B., Elliott, M. K., Mehta, V., Niederer, S., Chadwick, H., Kamdar, R., Adhya, S., Patel, N., Hamid, S., Rogers, D., Nicolson, W., Chan, C. F., Whinnett, Z., Murgatroyd, F., Lambiase, P. D., … Rinaldi, C. A. (2021). Standard care vs. TRIVEntricular pacing in Heart Failure (STRIVE HF): a prospective multicentre randomized controlled trial of triventricular pacing vs. conventional biventricular pacing in patients with heart failure and intermediate QRS left bundle branch block. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, euab267. Advance online publication. https://doi.org/10.1093/europace/euab267
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15134
    Collections
    Cardiology

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