New simpler methods to optimize cardiac resynchronization therapy (CRT) are being evaluated, such as the use of the electrocardiogram. In this prospective, double-blind, study, the investigators will evaluate: Primary endpoint: To compare the clinical response to CRT in patients with the programming optimized by QRS versus the nominal suggested by the device. Secondary endpoints: 1. To compare cardiac remodeling in patients with the programming optimized by QRS versus the nominal suggested by the device. 2. To evaluate the degree of asynchrony in both groups (nominal versus optimization by QRS) with respect to the intrinsic rhythm. 3. To evaluate the echocardiographic improvement in left ventricular (LV) filling in both groups. 4. To evaluate the differences in the optimal atrioventricular (AV) delay with atrial sensing or atrial pacing. For that, 180 patients with an indication for CRT will be randomized to nominal programming of the device or optimization by the electrocardiogram for a narrower QRS. A clinical and echocardiographic evaluation will be done at baseline, 6 and 12 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
180
CRT device is programmed to nominal values
CRT device is programmed by QRS optimization
Hospital Clinic de Barcelona
Barcelona, Spain
Clinical response
Clinical response: survival without heart transplantation or death and \>10% increased distance in the 6MWT.
Time frame: 12 months
Echocardiographic response
Echocardiographic response: \>15% decrease in LV end-systolic volume and survival without heart transplantation or death.
Time frame: 12 months
Pacing/sensing AV delay difference
Time frame: 12 months
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