Efficacy of a Device-Based Continuous Optimization Algorithm for Patients With Cardiac Resynchronization Therapy
Background:Cardiac resynchronization therapy (CRT) is less effective in patients with mildly wide QRS or non-left bundle branch block (non-LBBB). A new algorithm of every minute’s optimization (adaptive CRT: aCRT algorithm) is effective in patients with CRT devices. This study investigated the clini...
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| Veröffentlicht in: | Circulation Journal 2019/12/25, Vol.84(1), pp.18-25 |
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| creator | Ueda, Nobuhiko Noda, Takashi Ishibashi, Kohei Nakajima, Kenzaburo Kataoka, Naoya Kamakura, Tsukasa Wada, Mitsuru Yamagata, Kenichiro Inoue, Yuko Miyamoto, Koji Nagase, Satoshi Aiba, Takeshi Kanzaki, Hideaki Izumi, Chisato Noguchi, Teruo Yasuda, Satoshi Kusano, Kengo |
| description | Background:Cardiac resynchronization therapy (CRT) is less effective in patients with mildly wide QRS or non-left bundle branch block (non-LBBB). A new algorithm of every minute’s optimization (adaptive CRT: aCRT algorithm) is effective in patients with CRT devices. This study investigated the clinical effect of the aCRT algorithm, especially in mildly wide QRS (120≤QRS |
| doi_str_mv | 10.1253/circj.CJ-19-0691 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2309810246</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2309810246</sourcerecordid><originalsourceid>FETCH-LOGICAL-c494t-f1d8910320f86f92f475b34e5928f055192b0b2dcd6a51bc1013f425aa421e793</originalsourceid><addsrcrecordid>eNpFkM1v1DAQxS0EoqVw54R85JLi8Uc2PpbQAlWlIlTE0XKccderJA62F2n568l2t-1lZvT0e0-aR8h7YOfAlfjkQnKb8_a6Al2xWsMLcgpCrirZcPby4a4r3UhxQt7kvGGMa6b0a3IioFY1F_UpmS-9D866HY2eWvoF_waH1WebsadtnEqYtnGb6e1cwhj-2RLiRC-G-5hCWY_Ux0R_LCJOJdPfi0Rbm_pgHf2JeTe5dYrTo-tujcnOu7fklbdDxnfHfUZ-XV3etd-qm9uv39uLm8pJLUvloW80MMGZb2qvuZcr1QmJSvPGM6VA8451vHd9bRV0DhgIL7myVnLAlRZn5OMhd07xzxZzMWPIDofBTrh8ZLhgugHGZb2g7IC6FHNO6M2cwmjTzgAz-57NQ8-mvTagzb7nxfLhmL7tRuyfDI_FLsDVAdjkYu_xCbCpBDfgMbGRBvbjOfkZWNtkcBL_AVWvlCY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2309810246</pqid></control><display><type>article</type><title>Efficacy of a Device-Based Continuous Optimization Algorithm for Patients With Cardiac Resynchronization Therapy</title><source>MEDLINE</source><source>J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Ueda, Nobuhiko ; Noda, Takashi ; Ishibashi, Kohei ; Nakajima, Kenzaburo ; Kataoka, Naoya ; Kamakura, Tsukasa ; Wada, Mitsuru ; Yamagata, Kenichiro ; Inoue, Yuko ; Miyamoto, Koji ; Nagase, Satoshi ; Aiba, Takeshi ; Kanzaki, Hideaki ; Izumi, Chisato ; Noguchi, Teruo ; Yasuda, Satoshi ; Kusano, Kengo</creator><creatorcontrib>Ueda, Nobuhiko ; Noda, Takashi ; Ishibashi, Kohei ; Nakajima, Kenzaburo ; Kataoka, Naoya ; Kamakura, Tsukasa ; Wada, Mitsuru ; Yamagata, Kenichiro ; Inoue, Yuko ; Miyamoto, Koji ; Nagase, Satoshi ; Aiba, Takeshi ; Kanzaki, Hideaki ; Izumi, Chisato ; Noguchi, Teruo ; Yasuda, Satoshi ; Kusano, Kengo</creatorcontrib><description>Background:Cardiac resynchronization therapy (CRT) is less effective in patients with mildly wide QRS or non-left bundle branch block (non-LBBB). A new algorithm of every minute’s optimization (adaptive CRT: aCRT algorithm) is effective in patients with CRT devices. This study investigated the clinical effect of the aCRT algorithm, especially in mildly wide QRS (120≤QRS<150 ms) or non-LBBB patients receiving CRT.Methods and Results:This study included 104 CRT patients (48 patients using the aCRT algorithm [adaptive group] and 56 patients not using the aCRT algorithm [non-adaptive group]). The primary endpoint was a composite clinical outcome of cardiac death and/or heart failure (HF) hospitalization. During a median follow-up of 700 days (interquartile range 362–1,173 days), aCRT reduced the risk of the clinical outcome, even in patients with mildly wide QRS or non-LBBB (log-rank P=0.0030 and P=0.0077, respectively) by Kaplan-Meier analysis. Use of the aCRT algorithm was an independent predictor of clinical outcomes in the multivariate analysis (hazard ratio (HR) 0.28, 95% confidence interval (CI): 0.096–0.78, P=0.015), the same as in patients with mildly wide QRS (HR 0.12, 95% CI: 0.006–0.69, P=0.015).Conclusions:The new aCRT algorithm was useful and significantly reduced the risk of the clinical outcome, even in patients with mildly wide QRS.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-19-0691</identifier><identifier>PMID: 31656236</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Adaptive cardiac resynchronization therapy ; Aged ; Algorithms ; Bundle-Branch Block - mortality ; Bundle-Branch Block - physiopathology ; Bundle-Branch Block - therapy ; Cardiac Resynchronization Therapy ; Cardiac Resynchronization Therapy Devices ; Female ; Heart failure ; Heart Failure - mortality ; Heart Failure - physiopathology ; Heart Failure - therapy ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Mildly wide QRS ; Non-left bundle branch block ; Retrospective Studies</subject><ispartof>Circulation Journal, 2019/12/25, Vol.84(1), pp.18-25</ispartof><rights>2020 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c494t-f1d8910320f86f92f475b34e5928f055192b0b2dcd6a51bc1013f425aa421e793</citedby><cites>FETCH-LOGICAL-c494t-f1d8910320f86f92f475b34e5928f055192b0b2dcd6a51bc1013f425aa421e793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31656236$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ueda, Nobuhiko</creatorcontrib><creatorcontrib>Noda, Takashi</creatorcontrib><creatorcontrib>Ishibashi, Kohei</creatorcontrib><creatorcontrib>Nakajima, Kenzaburo</creatorcontrib><creatorcontrib>Kataoka, Naoya</creatorcontrib><creatorcontrib>Kamakura, Tsukasa</creatorcontrib><creatorcontrib>Wada, Mitsuru</creatorcontrib><creatorcontrib>Yamagata, Kenichiro</creatorcontrib><creatorcontrib>Inoue, Yuko</creatorcontrib><creatorcontrib>Miyamoto, Koji</creatorcontrib><creatorcontrib>Nagase, Satoshi</creatorcontrib><creatorcontrib>Aiba, Takeshi</creatorcontrib><creatorcontrib>Kanzaki, Hideaki</creatorcontrib><creatorcontrib>Izumi, Chisato</creatorcontrib><creatorcontrib>Noguchi, Teruo</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Kusano, Kengo</creatorcontrib><title>Efficacy of a Device-Based Continuous Optimization Algorithm for Patients With Cardiac Resynchronization Therapy</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background:Cardiac resynchronization therapy (CRT) is less effective in patients with mildly wide QRS or non-left bundle branch block (non-LBBB). A new algorithm of every minute’s optimization (adaptive CRT: aCRT algorithm) is effective in patients with CRT devices. This study investigated the clinical effect of the aCRT algorithm, especially in mildly wide QRS (120≤QRS<150 ms) or non-LBBB patients receiving CRT.Methods and Results:This study included 104 CRT patients (48 patients using the aCRT algorithm [adaptive group] and 56 patients not using the aCRT algorithm [non-adaptive group]). The primary endpoint was a composite clinical outcome of cardiac death and/or heart failure (HF) hospitalization. During a median follow-up of 700 days (interquartile range 362–1,173 days), aCRT reduced the risk of the clinical outcome, even in patients with mildly wide QRS or non-LBBB (log-rank P=0.0030 and P=0.0077, respectively) by Kaplan-Meier analysis. Use of the aCRT algorithm was an independent predictor of clinical outcomes in the multivariate analysis (hazard ratio (HR) 0.28, 95% confidence interval (CI): 0.096–0.78, P=0.015), the same as in patients with mildly wide QRS (HR 0.12, 95% CI: 0.006–0.69, P=0.015).Conclusions:The new aCRT algorithm was useful and significantly reduced the risk of the clinical outcome, even in patients with mildly wide QRS.</description><subject>Adaptive cardiac resynchronization therapy</subject><subject>Aged</subject><subject>Algorithms</subject><subject>Bundle-Branch Block - mortality</subject><subject>Bundle-Branch Block - physiopathology</subject><subject>Bundle-Branch Block - therapy</subject><subject>Cardiac Resynchronization Therapy</subject><subject>Cardiac Resynchronization Therapy Devices</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - therapy</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mildly wide QRS</subject><subject>Non-left bundle branch block</subject><subject>Retrospective Studies</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkM1v1DAQxS0EoqVw54R85JLi8Uc2PpbQAlWlIlTE0XKccderJA62F2n568l2t-1lZvT0e0-aR8h7YOfAlfjkQnKb8_a6Al2xWsMLcgpCrirZcPby4a4r3UhxQt7kvGGMa6b0a3IioFY1F_UpmS-9D866HY2eWvoF_waH1WebsadtnEqYtnGb6e1cwhj-2RLiRC-G-5hCWY_Ux0R_LCJOJdPfi0Rbm_pgHf2JeTe5dYrTo-tujcnOu7fklbdDxnfHfUZ-XV3etd-qm9uv39uLm8pJLUvloW80MMGZb2qvuZcr1QmJSvPGM6VA8451vHd9bRV0DhgIL7myVnLAlRZn5OMhd07xzxZzMWPIDofBTrh8ZLhgugHGZb2g7IC6FHNO6M2cwmjTzgAz-57NQ8-mvTagzb7nxfLhmL7tRuyfDI_FLsDVAdjkYu_xCbCpBDfgMbGRBvbjOfkZWNtkcBL_AVWvlCY</recordid><startdate>20191225</startdate><enddate>20191225</enddate><creator>Ueda, Nobuhiko</creator><creator>Noda, Takashi</creator><creator>Ishibashi, Kohei</creator><creator>Nakajima, Kenzaburo</creator><creator>Kataoka, Naoya</creator><creator>Kamakura, Tsukasa</creator><creator>Wada, Mitsuru</creator><creator>Yamagata, Kenichiro</creator><creator>Inoue, Yuko</creator><creator>Miyamoto, Koji</creator><creator>Nagase, Satoshi</creator><creator>Aiba, Takeshi</creator><creator>Kanzaki, Hideaki</creator><creator>Izumi, Chisato</creator><creator>Noguchi, Teruo</creator><creator>Yasuda, Satoshi</creator><creator>Kusano, Kengo</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20191225</creationdate><title>Efficacy of a Device-Based Continuous Optimization Algorithm for Patients With Cardiac Resynchronization Therapy</title><author>Ueda, Nobuhiko ; Noda, Takashi ; Ishibashi, Kohei ; Nakajima, Kenzaburo ; Kataoka, Naoya ; Kamakura, Tsukasa ; Wada, Mitsuru ; Yamagata, Kenichiro ; Inoue, Yuko ; Miyamoto, Koji ; Nagase, Satoshi ; Aiba, Takeshi ; Kanzaki, Hideaki ; Izumi, Chisato ; Noguchi, Teruo ; Yasuda, Satoshi ; Kusano, Kengo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c494t-f1d8910320f86f92f475b34e5928f055192b0b2dcd6a51bc1013f425aa421e793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adaptive cardiac resynchronization therapy</topic><topic>Aged</topic><topic>Algorithms</topic><topic>Bundle-Branch Block - mortality</topic><topic>Bundle-Branch Block - physiopathology</topic><topic>Bundle-Branch Block - therapy</topic><topic>Cardiac Resynchronization Therapy</topic><topic>Cardiac Resynchronization Therapy Devices</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - therapy</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mildly wide QRS</topic><topic>Non-left bundle branch block</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ueda, Nobuhiko</creatorcontrib><creatorcontrib>Noda, Takashi</creatorcontrib><creatorcontrib>Ishibashi, Kohei</creatorcontrib><creatorcontrib>Nakajima, Kenzaburo</creatorcontrib><creatorcontrib>Kataoka, Naoya</creatorcontrib><creatorcontrib>Kamakura, Tsukasa</creatorcontrib><creatorcontrib>Wada, Mitsuru</creatorcontrib><creatorcontrib>Yamagata, Kenichiro</creatorcontrib><creatorcontrib>Inoue, Yuko</creatorcontrib><creatorcontrib>Miyamoto, Koji</creatorcontrib><creatorcontrib>Nagase, Satoshi</creatorcontrib><creatorcontrib>Aiba, Takeshi</creatorcontrib><creatorcontrib>Kanzaki, Hideaki</creatorcontrib><creatorcontrib>Izumi, Chisato</creatorcontrib><creatorcontrib>Noguchi, Teruo</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Kusano, Kengo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ueda, Nobuhiko</au><au>Noda, Takashi</au><au>Ishibashi, Kohei</au><au>Nakajima, Kenzaburo</au><au>Kataoka, Naoya</au><au>Kamakura, Tsukasa</au><au>Wada, Mitsuru</au><au>Yamagata, Kenichiro</au><au>Inoue, Yuko</au><au>Miyamoto, Koji</au><au>Nagase, Satoshi</au><au>Aiba, Takeshi</au><au>Kanzaki, Hideaki</au><au>Izumi, Chisato</au><au>Noguchi, Teruo</au><au>Yasuda, Satoshi</au><au>Kusano, Kengo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of a Device-Based Continuous Optimization Algorithm for Patients With Cardiac Resynchronization Therapy</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2019-12-25</date><risdate>2019</risdate><volume>84</volume><issue>1</issue><spage>18</spage><epage>25</epage><pages>18-25</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background:Cardiac resynchronization therapy (CRT) is less effective in patients with mildly wide QRS or non-left bundle branch block (non-LBBB). A new algorithm of every minute’s optimization (adaptive CRT: aCRT algorithm) is effective in patients with CRT devices. This study investigated the clinical effect of the aCRT algorithm, especially in mildly wide QRS (120≤QRS<150 ms) or non-LBBB patients receiving CRT.Methods and Results:This study included 104 CRT patients (48 patients using the aCRT algorithm [adaptive group] and 56 patients not using the aCRT algorithm [non-adaptive group]). The primary endpoint was a composite clinical outcome of cardiac death and/or heart failure (HF) hospitalization. During a median follow-up of 700 days (interquartile range 362–1,173 days), aCRT reduced the risk of the clinical outcome, even in patients with mildly wide QRS or non-LBBB (log-rank P=0.0030 and P=0.0077, respectively) by Kaplan-Meier analysis. Use of the aCRT algorithm was an independent predictor of clinical outcomes in the multivariate analysis (hazard ratio (HR) 0.28, 95% confidence interval (CI): 0.096–0.78, P=0.015), the same as in patients with mildly wide QRS (HR 0.12, 95% CI: 0.006–0.69, P=0.015).Conclusions:The new aCRT algorithm was useful and significantly reduced the risk of the clinical outcome, even in patients with mildly wide QRS.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>31656236</pmid><doi>10.1253/circj.CJ-19-0691</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adaptive cardiac resynchronization therapy Aged Algorithms Bundle-Branch Block - mortality Bundle-Branch Block - physiopathology Bundle-Branch Block - therapy Cardiac Resynchronization Therapy Cardiac Resynchronization Therapy Devices Female Heart failure Heart Failure - mortality Heart Failure - physiopathology Heart Failure - therapy Humans Kaplan-Meier Estimate Male Middle Aged Mildly wide QRS Non-left bundle branch block Retrospective Studies |
| title | Efficacy of a Device-Based Continuous Optimization Algorithm for Patients With Cardiac Resynchronization Therapy |
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