INTRODUCTION: There are no randomized controlled trial data that evaluate mortality and hospitalization rates in cardiac resynchronization therapy (CRT) recipients based on left ventricular (LV) lead location. We analyzed the event-driven outcomes of mortality and hospitalization as well as functional outcomes including Functional Class, Quality-of-Life, and 6-minute walk distance in 1,520 patients enrolled in the COMPANION study of CRT versus optimal medical therapy. METHODS AND RESULTS: Over a mean follow-up after implantation of 16.2 months, patients randomized to CRT, regardless of lead location, experienced benefit compared with optimized pharmacologic therapy (OPT), with respect to all-cause mortality or heart failure hospitalization. All but a posterior location showed benefit with respect to the all-cause mortality or all-cause hospitalization outcome. Mortality benefit in CRT-D patients was indifferent to LV lead position. All functional outcomes including 6-minute walk distance, Quality-of-Life (QOL) and Functional Class improved with CRT, regardless of LV lead location. CONCLUSION: LV lead location was not a major determinant of multiple measures of response to CRT therapy in the COMPANION Trial. While acute data indicate that a left lateral LV lead location results in the most favorable hemodynamic response, these chronic data suggest that positioning an LV lead in an anterior rather than a lateral or posterior LV location has similar benefit.
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INTRODUCTION: There are no randomized controlled trial data that evaluate mortality and hospitalization rates in cardiac resynchronization therapy (CRT) recipients based on left ventricular (LV) lead location. We analyzed the event-driven outcomes of mortality and hospitalization as well as functional outcomes including Functional Class, Quality-of-Life, and 6-minute walk distance in 1,520 patients enrolled in the COMPANION study of CRT versus optimal medical therapy. METHODS AND RESULTS: Over a mean follow-up after implantation of 16.2 months, patients randomized to CRT, regardless of lead location, experienced benefit compared with optimized pharmacologic therapy (OPT), with respect to all-cause mortality or heart failure hospitalization. All but a posterior location showed benefit with respect to the all-cause mortality or all-cause hospitalization outcome. Mortality benefit in CRT-D patients was indifferent to LV lead position. All functional outcomes including 6-minute walk distance, Quality-of-Life (QOL) and Functional Class improved with CRT, regardless of LV lead location. CONCLUSION: LV lead location was not a major determinant of multiple measures of response to CRT therapy in the COMPANION Trial. While acute data indicate that a left lateral LV lead location results in the most favorable hemodynamic response, these chronic data suggest that positioning an LV lead in an anterior rather than a lateral or posterior LV location has similar benefit.
Authors: Robert K Altman; Kimberly A Parks; Christopher L Schlett; Mary Orencole; Mi-Young Park; Quynh A Truong; Peerawut Deeprasertkul; Stephanie A Moore; Conor D Barrett; Gregory D Lewis; Saumya Das; Gaurav A Upadhyay; E Kevin Heist; Michael H Picard; Jagmeet P Singh Journal: Eur Heart J Date: 2012-05-21 Impact factor: 29.983
Authors: Chin C Lee; Khuyen Do; Sati Patel; Steven K Carlson; Tomas Konecny; Philip M Chang; Rahul N Doshi Journal: J Interv Card Electrophysiol Date: 2019-08-20 Impact factor: 1.900
Authors: Alexander P Benz; Mate Vamos; Julia W Erath; Peter Bogyi; Gabor Z Duray; Stefan H Hohnloser Journal: Clin Res Cardiol Date: 2018-05-24 Impact factor: 5.460
Authors: Lu Chen; Jay E Tiongson; Sebastian Obrzut; Martin B McDaniel; Hsin-Yi Chang; Jigar Patel; Paul J Friedman; Gregory K Feld; Ulrika M Birgersdotter-Green Journal: J Interv Card Electrophysiol Date: 2012-07-28 Impact factor: 1.900