CLINICAL STUDY
Long-term benefits of biventricular pacing in congestive heart failure: results from the MUltisite STimulation in cardiomyopathy (MUSTIC) study
Cecilia Linde, MD, PhD*,*,
Christophe Leclercq, MD, PhD ,
Steve Rex, MD ,
Stephane Garrigue, MD ,
Thomas Lavergne, MD||,
Serge Cazeau, MD¶,
William McKenna, MD#,
Melissa Fitzgerald, MBBS**,
Jean-Claude Deharo, MD,
Christine Alonso, MD,
Stuart Walker, MD,
Frieder Braunschweig, MD*,
Christophe Bailleul, PhD,
Jean-Claude Daubert, MD on behalf of the MUltisite STimulation In Cardiomyopathies (MUSTIC) Study Group
* Department of Cardiology, Karolinska Hospital, Stockholm, Sweden
Department de Cardiologie, CHU, Rennes, France
Department of Cardiology, Harefield Hospital, Harefield, United Kingdom
Hôpital Cardiologique du Haut Levêque, Bordeaux, France
|| Department de Cardiologie, HEGP, Paris, France
¶ Department of Cardiology, InParys, Saint-Cloud, France
# St George’s Hospital, St George’s, United Kingdom
** Derriford Hospital, Plymouth, United Kingdom
Service de Cardiologie, Hôpital Sainte-Marguerite, Marseille, France
Department de Recherche Clinique, ELA Recherche, Le Plessis-Robinson, France
Manuscript received August 28, 2001;
revised manuscript received March 20, 2002,
accepted April 5, 2002.
* Reprint requests and correspondence: Dr. Cecilia Linde, Department of Cardiology, Karolinska Hospital, 117 76 Stockholm, Sweden.
cecilia.linde{at}ks.se
OBJECTIVES: The main objective of this study was to assess if the benefits of biventricular (BiV) pacing observed during the crossover phase were sustained over 12 months.
BACKGROUND: MUltisite STimulation In Cardiomyopathies (MUSTIC) is a randomized controlled study intended to evaluate the effects of BiV pacing in patients with New York Heart Association (NYHA) class III heart failure and intraventricular conduction delay.
METHODS: Of 131 patients included, 42/67 in sinus rhythm (SR) and 33/64 in atrial fibrillation (AF) were followed up longitudinally at 9 and 12 months by 6-min walked distance, peak oxygen uptake (peak VO2), quality of life by the Minnesota score, NYHA class, echocardiography, and left ventricular ejection fraction by radionuclide technique.
RESULTS: At 12 months, all SR and 88% of AF patients were programmed to BiV pacing. Compared with baseline, the 6-min walked distance increased by 20% (SR) (p = 0.0001) and 17% (AF) (p = 0.004); the peak VO2 by 11% (SR) and 9% (AF); quality of life improved by 36% (SR) (p = 0.0001) and 32% (AF) (p = 0.002); NYHA class improved by 25% (SR) (p = 0.0001) and 27% (AF) (p = 0.0001). The ejection fraction improved by 5% (SR) and 4% (AF). Mitral regurgitation decreased by 45% (SR) and 50% (AF).
CONCLUSIONS: The clinical benefits of BiV pacing appeared to be significantly maintained over a 12-month follow-up period.
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Abbreviations and Acronyms
| | ACE | | angiotensin-converting enzyme | | AF | | atrial fibrillation | | AV | | atrioventricular | | BiV | | biventricular | | BP | | blood pressure | | CT | | cardiothoracic | | HF | | heart failure | | HR | | heart rate | | LV | | left ventricle/ventricular | | MUSTIC | | MUltisite STimulation In Cardiomyopathies | | NYHA | | New York Heart Association | | RV | | right ventricle/ventricular | | SR | | sinus rhythm | | VVIR | | rate adaptive ventricular inhibited pacing |
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M. Schmidt, J. Bromsen, C. Herholz, K. Adler, F. Neff, C. Kopf, and M. Block
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M. Cannesson, B. Gostoli, P. Rosamel, C. Flamens, G. Derumeaux, P. Chevallier, J.-F. Obadia, O. Bastien, and J.-J. Lehot
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V. J. Dzau, E. M. Antman, H. R. Black, D. L. Hayes, J. E. Manson, J. Plutzky, J. J. Popma, and W. Stevenson
The Cardiovascular Disease Continuum Validated: Clinical Evidence of Improved Patient Outcomes: Part II: Clinical Trial Evidence (Acute Coronary Syndromes Through Renal Disease) and Future Directions
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M. Rivero-Ayerza, D. A.M.J. Theuns, H. M. Garcia-Garcia, E. Boersma, M. Simoons, and L. J. Jordaens
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C. Ypenburg, M. J. Schalij, G. B. Bleeker, P. Steendijk, E. Boersma, P. Dibbets-Schneider, M. P. Stokkel, E. E. van der Wall, and J. J. Bax
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L. Riedlbauchova, R. Cihaak, J. Bytesnik, V. Vancura, P. Fridl, L. Hoskovaa, and J. Kautzner
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E Agricola, M Oppizzi, M Galderisi, M Pisani, A Meris, C Pappone, and A Margonato
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M. Gasparini, A. Auricchio, F. Regoli, C. Fantoni, M. Kawabata, P. Galimberti, D. Pini, C. Ceriotti, E. Gronda, C. Klersy, et al.
Four-Year Efficacy of Cardiac Resynchronization Therapy on Exercise Tolerance and Disease Progression: The Importance of Performing Atrioventricular Junction Ablation in Patients With Atrial Fibrillation
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R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al.
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C. Ypenburg, L. van Erven, G. B. Bleeker, J. J. Bax, M. Bootsma, M. C. Wijffels, E. E. van der Wall, and M. J. Schalij
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U. C. Hoppe, J. M. Casares, H. Eiskjaer, A. Hagemann, J. G.F. Cleland, N. Freemantle, and E. Erdmann
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P. Lechat
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E. Occhetta, M. Bortnik, A. Magnani, G. Francalacci, C. Piccinino, L. Plebani, and P. Marino
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E. Donal, C. Leclercq, C. Linde, and J.-C. Daubert
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P A Mehta and M R Cowie
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O. Lindner, J. Sorensen, J. Vogt, E. Fricke, D. Baller, D. Horstkotte, and W. Burchert
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M. S. Suffoletto, K. Dohi, M. Cannesson, S. Saba, and J. Gorcsan III
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