| Cardiac resynchronization with sequential biventricular pacing for the treatment of moderate-to-severe heart failure. | |
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MedLine Citation:
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PMID: 16360062 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The InSync III study evaluated sequential cardiac resynchronization therapy (CRT) in patients with moderate-to-severe heart failure and prolonged QRS. BACKGROUND: Simultaneous CRT improves hemodynamic and clinical performance in patients with moderate-to-severe heart failure (HF) and a wide QRS. Recent evidence suggests that sequentially stimulating the ventricles might provide additional benefit. METHODS: This multicenter, prospective, nonrandomized, six-month trial enrolled a total of 422 patients to determine the effectiveness of sequential CRT in patients with New York Heart Association (NYHA) functional class III or IV HF and a prolonged QRS. The study evaluated: whether patients receiving sequential CRT for six months experienced improvement in 6-min hall walk (6MHW) distance, NYHA functional class, and quality of life (QoL) over control group patients from the reported Multicenter InSync Randomized Clinical Evaluation (MIRACLE) trial; whether sequential CRT increased stroke volume compared to simultaneous CRT; and whether an increase in stroke volume translated into greater clinical improvements compared to patients receiving simultaneous CRT. RESULTS: InSync III patients experienced greater improvement in 6MHW, NYHA functional class, and QoL at six months compared to control (all p < 0.0001). Optimization of the sequential pacing increased (median 7.3%) stroke volume in 77% of patients. No additional improvement in NYHA functional class or QoL was seen compared to the simultaneous CRT group; however, InSync III patients demonstrated greater exercise capacity. CONCLUSIONS: Sequential CRT provided most patients with a modest increase in stroke volume above that achieved during simultaneous CRT. Patients receiving sequential CRT had improved exercise capacity, but no change in functional status or QoL. |
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Authors:
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Angel R León; William T Abraham; Susan Brozena; James P Daubert; Westby G Fisher; John C Gurley; Chang Seng Liang; George Wong; |
Publication Detail:
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Type: Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 46 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2005 Dec |
Date Detail:
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Created Date: 2005-12-19 Completed Date: 2006-03-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2298-304 Citation Subset: AIM; IM |
Affiliation:
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Carlyle Fraser Heart Center/Division of Cardiology, Emory University, Atlanta, Georgia, USA. angel_leon@emoryhealthcare.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Output, Low / diagnosis, physiopathology*, therapy* Cardiac Pacing, Artificial / methods* Electrocardiography Female Hemodynamics Humans Male Middle Aged Quality of Life Severity of Illness Index Time Factors Treatment Outcome Walking |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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