Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction

European Heart Journal
Gregg W StonePRomPT Trial Investigators

Abstract

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). 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...Continue Reading

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Citations

Feb 3, 2016·European Heart Journal·Thomas F Lüscher
Oct 29, 2015·European Heart Journal·Christophe LeclercqFrank Ruschitzka
Sep 29, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Shukri W DavidGregg W Stone
Apr 8, 2017·Basic Research in Cardiology·André UitterdijkDirk J Duncker
Jan 11, 2021·Molecular and Cellular Biochemistry·Rajshekhar A KoreJawahar L Mehta

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