Targeted left ventricular lead positioning to the site of latest activation in cardiac resynchronization therapy: a systematic review and meta-analysis.
Targeted left ventricular lead positioning to the site of latest activation in cardiac resynchronization therapy: a systematic review and meta-analysis.
复制标题
DOI：
10.1093/europace/euad267
复制
发表时间：
2023-08-02
期刊：
影响因子：
6.1
通讯作者：
Nielsen, Jens Cosedis
中科院分区：
文献类型：
--
作者：
Fyenbo, Daniel Benjamin;Bjerre, Henrik Laurits;Frausing, Maria Hee Jung Park;Stephansen, Charlotte;Sommer, Anders;Borgquist, Rasmus;Bakos, Zoltan;Glikson, Michael;Milman, Anat;Beinart, Roy;Kockova, Radka;Sedlacek, Kamil;Wichterle, Dan;Saba, Samir;Jain, Sandeep;Shalaby, Alaa;Kronborg, Mads Brix;Nielsen, Jens Cosedis
关键词：
一些研究已经评估了在心脏再同步化治疗（CRT）受者中使用电或成像引导左心室（LV）导联。我们的目的是评估一种引导策略的证据，该策略将左室导联位置定位到最新的左室激活位点。到2023年3月，对随机对照试验（rct）进行了系统回顾和荟萃分析，评估了电或成像引导下左室导联定位对临床和超声心动图结果的影响。主要终点是全因死亡率和心力衰竭住院治疗的综合结果，次要终点是生活质量、6分钟步行试验（6MWT）、QRS持续时间、左室收缩末期容积和左室射血分数。我们纳入了8项随机对照试验，共1323例患者。6项rct比较了引导策略（n = 638）和常规策略（n = 468）， 2项rct比较了不同的引导策略：电引导（n = 111）和成像引导（n = 106）。与常规治疗相比，指导策略在12-24个月后没有显著降低主要终点的风险（RR 0.83, 95% CI 0.52-1.33）。在6个月的随访后，引导策略与组间6MWT距离的轻微改善相关，绝对18 (95% CI 6 - 30) m，但其余次要终点没有改善。两种指导策略的次要终点均无差异。在这项研究中，针对最新左室激活的CRT植入策略并没有提高生存率或减少心力衰竭住院率。
Several studies have evaluated the use of electrically- or imaging-guided left ventricular (LV) lead placement in cardiac resynchronization therapy (CRT) recipients. We aimed to assess evidence for a guided strategy that targets LV lead position to the site of latest LV activation. A systematic review and meta-analysis was performed for randomized controlled trials (RCTs) until March 2023 that evaluated electrically- or imaging-guided LV lead positioning on clinical and echocardiographic outcomes. The primary endpoint was a composite of all-cause mortality and heart failure hospitalization, and secondary endpoints were quality of life, 6-min walk test (6MWT), QRS duration, LV end-systolic volume, and LV ejection fraction. We included eight RCTs that comprised 1323 patients. Six RCTs compared guided strategy (n = 638) to routine (n = 468), and two RCTs compared different guiding strategies head-to-head: electrically- (n = 111) vs. imaging-guided (n = 106). Compared to routine, a guided strategy did not significantly reduce the risk of the primary endpoint after 12–24 (RR 0.83, 95% CI 0.52–1.33) months. A guided strategy was associated with slight improvement in 6MWT distance after 6 months of follow-up of absolute 18 (95% CI 6–30) m between groups, but not in remaining secondary endpoints. None of the secondary endpoints differed between the guided strategies. In this study, a CRT implantation strategy that targets the latest LV activation did not improve survival or reduce heart failure hospitalizations.
登录
查看更多内容
影响因子：
2.1
作者：
Jin Y;Zhang Q;Mao JL;He B
通讯作者：
He B
影响因子：
1.9
作者：
Sami, Abdul;Mustafa, Bilal;Butt, Hamza Ahmed;Ashraf, Zainab;Ullah, Asif;Babar, Farheen;Asad, Muhammad;Awais, Muhammad;Zaidi, Syed Muhammad Jawad;Fakhar, Tehniat;Mehmoodi, Amin;Adnan, Nawal;Malik, Jahanzeb
通讯作者：
Malik, Jahanzeb
影响因子：
37.8
作者：
Delgado, Victoria;van Bommel, Rutger J.;Bax, Jeroen J.
通讯作者：
Bax, Jeroen J.
多模态心脏成像引导下的心脏再同步化治疗
影响因子：
18.2
作者：
Bertini, Matteo;Mele, Donato;Ferrari, Roberto
通讯作者：
Ferrari, Roberto
影响因子：
13
作者：
Kydd, Anna C.;Khan, Fakhar Z.;Dutka, David P.
通讯作者：
Dutka, David P.