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

Justin Gould*, Simon Claridge, Thomas Jackson, Benjamin J. Sieniewicz, Baldeep S. Sidhu, Bradley Porter, Mark K. Elliott, Vishal Mehta, Steven Niederer, Humra Chadwick, Ravi Kamdar, Shaumik Adhya, Nikhil Patel, Shoaib Hamid, Dominic Rogers, William Nicolson, Cheuk F. Chan, Zachary Whinnett, Francis Murgatroyd, Pier D. LambiaseChristopher A. Rinaldi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)796-806
Number of pages11
JournalEuropace
Volume24
Issue number5
DOIs
Publication statusPublished - 2022

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