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J Am Coll Cardiol, 2002; 40:111-118 © 2002 by the American College of Cardiology Foundation |
* 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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