Targeted Left Ventricular Lead Placement to Guide Cardiac Resynchronization Therapy

医学 心脏再同步化治疗 临床终点 心脏病学 内科学 心力衰竭 置信区间 铅(地质) 随机对照试验 随机化
作者
Fakhar Z. Khan,Mumohan S. Virdee,Christopher R. Palmer,Peter J. Pugh,Denis O’Halloran,Maros Elsik,Philip A. Read,David Begley,Simon P. Fynn,David P. Dutka
出处
期刊:Journal of the American College of Cardiology [Elsevier BV]
卷期号:59 (17): 1509-1518 被引量:506
标识
DOI:10.1016/j.jacc.2011.12.030
摘要

This study sought to assess the impact of targeted left ventricular (LV) lead placement on outcomes of cardiac resynchronization therapy (CRT). Placement of the LV lead to the latest sites of contraction and away from the scar confers the best response to CRT. We conducted a randomized, controlled trial to compare a targeted approach to LV lead placement with usual care. A total of 220 patients scheduled for CRT underwent baseline echocardiographic speckle-tracking 2-dimensional radial strain imaging and were then randomized 1:1 into 2 groups. In group 1 (TARGET [Targeted Left Ventricular Lead Placement toGuide Cardiac Resynchronization Therapy]), the LV lead was positioned at the latest site of peak contraction with an amplitude of >10% to signify freedom from scar. In group 2 (control) patients underwent standard unguided CRT. Patients were classified by the relationship of the LV lead to the optimal site as concordant (at optimal site), adjacent (within 1 segment), or remote (≥2 segments away). The primary endpoint was a ≥15% reduction in LV end-systolic volume at 6 months. Secondary endpoints were clinical response (≥1 improvement in New York Heart Association functional class), all-cause mortality, and combined all-cause mortality and heart failure–related hospitalization. The groups were balanced at randomization. In the TARGET group, there was a greater proportion of responders at 6 months (70% vs. 55%, p = 0.031), giving an absolute difference in the primary endpoint of 15% (95% confidence interval: 2% to 28%). Compared with controls, TARGET patients had a higher clinical response (83% vs. 65%, p = 0.003) and lower rates of the combined endpoint (log-rank test, p = 0.031). Compared with standard CRT treatment, the use of speckle-tracking echocardiography to the target LV lead placement yields significantly improved response and clinical status and lower rates of combined death and heart failure–related hospitalization. (Targeted Left Ventricular Lead Placement to Guide Cardiac Resynchronization Therapy [TARGET] study); ISRCTN19717943 )
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
大橙子发布了新的文献求助10
1秒前
wzhang完成签到,获得积分10
2秒前
ken131完成签到 ,获得积分10
5秒前
myl完成签到,获得积分10
6秒前
728完成签到,获得积分10
12秒前
xiaofeng5838完成签到,获得积分10
12秒前
ronnie完成签到,获得积分10
12秒前
15秒前
寒冷芷蕊完成签到,获得积分20
15秒前
15秒前
Jane完成签到,获得积分10
15秒前
一氧化二氢完成签到,获得积分10
21秒前
凡事发生必有利于我完成签到,获得积分10
22秒前
yihaiqin完成签到 ,获得积分10
26秒前
轩辕剑身完成签到,获得积分0
26秒前
coolkid完成签到 ,获得积分0
27秒前
你怎么那么美完成签到,获得积分10
27秒前
游艺完成签到 ,获得积分10
30秒前
冬月完成签到 ,获得积分10
30秒前
薛乎虚完成签到 ,获得积分10
31秒前
32秒前
大胖完成签到,获得积分10
32秒前
野火197完成签到,获得积分10
36秒前
37秒前
量子星尘发布了新的文献求助10
40秒前
April完成签到,获得积分10
40秒前
周舟完成签到 ,获得积分10
43秒前
V_I_G完成签到 ,获得积分10
44秒前
nick完成签到,获得积分10
45秒前
高高高完成签到 ,获得积分10
48秒前
彪壮的亦瑶完成签到 ,获得积分10
49秒前
科研通AI2S应助科研通管家采纳,获得10
51秒前
Perry应助科研通管家采纳,获得60
51秒前
Akim应助科研通管家采纳,获得10
51秒前
鱼雷完成签到,获得积分10
52秒前
廿伊发布了新的文献求助10
54秒前
我是125完成签到,获得积分10
56秒前
依人如梦完成签到 ,获得积分10
57秒前
58秒前
PDIF-CN2完成签到,获得积分10
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038157
求助须知:如何正确求助?哪些是违规求助? 3575869
关于积分的说明 11373842
捐赠科研通 3305650
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022