Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction
Research output: Contribution to journal › Journal article › Research › peer-review
AIMS: We sought to determine whether peri-infarct pacing prevents left ventricular (LV) remodelling and improves functional and clinical outcomes in patients with large first myocardial infarction (MI).
METHODS AND RESULTS: A total of 126 patients at 27 international sites within 10 days of onset of anterior or non-anterior MI with creatine phosphokinase >3000 U/L and QRS duration ≤120 ms were randomized 1:1:1 to dual-site biventricular pacing vs. single-site LV only pacing vs. non-implanted control. The primary endpoint was the echocardiographic core laboratory-assessed change in LV end-diastolic volume (ΔLVEDV) from baseline to 18 months between the pooled pacing therapy groups and the control group. ΔLVEDV increased by 15.3 ± 28.6 mL in the control group and by 16.7 ± 30.5 mL in the pooled pacing groups during follow-up (adjusted mean difference (95% CI) = 0.6 (-12.3, 13.5) mL, P = 0.92). There were also no significant between-group differences in the change in LV end-systolic volume or ejection fraction over time. Quality of life, as assessed by the Minnesota Living with Heart Failure (HF) and European Quality of Life-5 Dimension questionnaires and New York Heart Association class, was also similar between groups during 18-month follow-up. Six-minute walk distance improved during follow-up to an equal degree between groups, and there were no significant differences in the 18-month rates of death or HF hospitalization between the pooled pacing therapy vs. control groups (17.4 vs. 21.7% respectively, P = 0.59).
CONCLUSIONS: In the present multicentre, randomized trial, peri-infarct pacing did not prevent LV remodelling or improve functional or clinical outcomes during 18-month follow-up in patients with large first MI.
CLINICALTRIALSGOV IDENTIFIER: NCT01213251.
Original language | English |
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Journal | European Heart Journal |
Volume | 37 |
Issue number | 5 |
Pages (from-to) | 484-93 |
Number of pages | 10 |
ISSN | 0195-668X |
DOIs | |
Publication status | Published - 1 Feb 2016 |
- Cardiac Resynchronization Therapy, Female, Heart Failure, Humans, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Stroke Volume, Treatment Outcome, Ventricular Remodeling, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
Research areas
ID: 176471206