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Multipoint pacing for cardiac resynchronisation therapy in patients with heart failure: a systematic review and meta-analysis

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Multipoint pacing for cardiac resynchronisation therapy in patients with heart failure: a systematic review and meta-analysis. / Mehta, Vishal; Elliott, Mark; Sidhu, Baldeep et al.

In: Journal of Cardiovascular Electrophysiology, 21.07.2021.

Research output: Contribution to journalReview articlepeer-review

Harvard

Mehta, V, Elliott, M, Sidhu, B, Gould, J, Porter, B, Niederer, S & Rinaldi, CA 2021, 'Multipoint pacing for cardiac resynchronisation therapy in patients with heart failure: a systematic review and meta-analysis', Journal of Cardiovascular Electrophysiology.

APA

Mehta, V., Elliott, M., Sidhu, B., Gould, J., Porter, B., Niederer, S., & Rinaldi, C. A. (Accepted/In press). Multipoint pacing for cardiac resynchronisation therapy in patients with heart failure: a systematic review and meta-analysis. Journal of Cardiovascular Electrophysiology.

Vancouver

Mehta V, Elliott M, Sidhu B, Gould J, Porter B, Niederer S et al. Multipoint pacing for cardiac resynchronisation therapy in patients with heart failure: a systematic review and meta-analysis. Journal of Cardiovascular Electrophysiology. 2021 Jul 21.

Author

Mehta, Vishal ; Elliott, Mark ; Sidhu, Baldeep et al. / Multipoint pacing for cardiac resynchronisation therapy in patients with heart failure: a systematic review and meta-analysis. In: Journal of Cardiovascular Electrophysiology. 2021.

Bibtex Download

@article{349c907fd51f49808acf23f4983cc032,
title = "Multipoint pacing for cardiac resynchronisation therapy in patients with heart failure: a systematic review and meta-analysis",
abstract = "Introduction Multipoint pacing (MPP) has been proposed as an effective way to improve cardiac resynchronisation therapy (CRT) response. We performed a systematic review and meta-analysis evaluating the efficacy of CRT delivered via MPP compared to conventional CRT. Methods A literature search was performed from inception to January 2021 for studies in Medline, Embase and Cochrane databases, comparing MPP to conventional CRT with a minimum of 6 months follow-up. Randomised and non-randomised studies were assessed for relevant efficacy data including echocardiographic (LVESV and EF) or functional changes (NYHA class/Clinical Composite Score (CCS)). Subgroup analyses were performed by study design and programming type. Results 7 studies with a total of 1390 patients were included in the final analysis. Overall, MPP demonstrated greater echocardiographic improvement than conventional CRT in non-randomised studies [OR 5.33, 95% CI[3.05-9.33], p<0.001], however was not significant in randomised studies [OR 1.86, 95% CI[0.91-3.79], p=0.086]. There was no significant difference in LVESV reduction >15% [OR 1.96, 95% CI[0.69-5.55], p=0.20] or improvement by ≥1 NYHA class [OR 2.49, 95% CI[0.74-8.42], p=0.141] when comparing MPP to conventional CRT. In a sub-analysis, MPP programmed by widest anatomical separation (MPP-AS) signalled greater efficacy, however only 120 patients were included in this analysis. Conclusion Overall MPP was more efficacious in non-randomised studies, and not superior when assessed in randomised studies. There was considerable heterogeneity in study design making overall interpretation of results challenging. Widespread MPP programming in all CRT patients is currently not justified. Further large, randomised studies with patient-specific programming may clarify its effectiveness. ",
author = "Vishal Mehta and Mark Elliott and Baldeep Sidhu and Justin Gould and Bradley Porter and Steven Niederer and Rinaldi, {Christopher Aldo}",
year = "2021",
month = jul,
day = "21",
language = "English",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Multipoint pacing for cardiac resynchronisation therapy in patients with heart failure: a systematic review and meta-analysis

AU - Mehta, Vishal

AU - Elliott, Mark

AU - Sidhu, Baldeep

AU - Gould, Justin

AU - Porter, Bradley

AU - Niederer, Steven

AU - Rinaldi, Christopher Aldo

PY - 2021/7/21

Y1 - 2021/7/21

N2 - Introduction Multipoint pacing (MPP) has been proposed as an effective way to improve cardiac resynchronisation therapy (CRT) response. We performed a systematic review and meta-analysis evaluating the efficacy of CRT delivered via MPP compared to conventional CRT. Methods A literature search was performed from inception to January 2021 for studies in Medline, Embase and Cochrane databases, comparing MPP to conventional CRT with a minimum of 6 months follow-up. Randomised and non-randomised studies were assessed for relevant efficacy data including echocardiographic (LVESV and EF) or functional changes (NYHA class/Clinical Composite Score (CCS)). Subgroup analyses were performed by study design and programming type. Results 7 studies with a total of 1390 patients were included in the final analysis. Overall, MPP demonstrated greater echocardiographic improvement than conventional CRT in non-randomised studies [OR 5.33, 95% CI[3.05-9.33], p<0.001], however was not significant in randomised studies [OR 1.86, 95% CI[0.91-3.79], p=0.086]. There was no significant difference in LVESV reduction >15% [OR 1.96, 95% CI[0.69-5.55], p=0.20] or improvement by ≥1 NYHA class [OR 2.49, 95% CI[0.74-8.42], p=0.141] when comparing MPP to conventional CRT. In a sub-analysis, MPP programmed by widest anatomical separation (MPP-AS) signalled greater efficacy, however only 120 patients were included in this analysis. Conclusion Overall MPP was more efficacious in non-randomised studies, and not superior when assessed in randomised studies. There was considerable heterogeneity in study design making overall interpretation of results challenging. Widespread MPP programming in all CRT patients is currently not justified. Further large, randomised studies with patient-specific programming may clarify its effectiveness.

AB - Introduction Multipoint pacing (MPP) has been proposed as an effective way to improve cardiac resynchronisation therapy (CRT) response. We performed a systematic review and meta-analysis evaluating the efficacy of CRT delivered via MPP compared to conventional CRT. Methods A literature search was performed from inception to January 2021 for studies in Medline, Embase and Cochrane databases, comparing MPP to conventional CRT with a minimum of 6 months follow-up. Randomised and non-randomised studies were assessed for relevant efficacy data including echocardiographic (LVESV and EF) or functional changes (NYHA class/Clinical Composite Score (CCS)). Subgroup analyses were performed by study design and programming type. Results 7 studies with a total of 1390 patients were included in the final analysis. Overall, MPP demonstrated greater echocardiographic improvement than conventional CRT in non-randomised studies [OR 5.33, 95% CI[3.05-9.33], p<0.001], however was not significant in randomised studies [OR 1.86, 95% CI[0.91-3.79], p=0.086]. There was no significant difference in LVESV reduction >15% [OR 1.96, 95% CI[0.69-5.55], p=0.20] or improvement by ≥1 NYHA class [OR 2.49, 95% CI[0.74-8.42], p=0.141] when comparing MPP to conventional CRT. In a sub-analysis, MPP programmed by widest anatomical separation (MPP-AS) signalled greater efficacy, however only 120 patients were included in this analysis. Conclusion Overall MPP was more efficacious in non-randomised studies, and not superior when assessed in randomised studies. There was considerable heterogeneity in study design making overall interpretation of results challenging. Widespread MPP programming in all CRT patients is currently not justified. Further large, randomised studies with patient-specific programming may clarify its effectiveness.

M3 - Review article

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

ER -

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