{"id":"60aca5a95165","type":"article","url":"https://hartvaat.nl/2016/02/01/peri-infarctpacing-ter-preventie-van-linkerkamerremodellering-na-groot-myocardin/","title":"Peri-infarctpacing ter preventie van linkerkamerremodellering na groot myocardinfarct","title_en":"Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["linkerbundeltakpacing","myocardinfarct","ouderen","secundaire-preventie"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehv436","source_url":"https://doi.org/10.1093/eurheartj/ehv436","authors":["Gregg W Stone","Eugene S Chung","Branislav Stancak","Jesper H Svendsen","Trent M Fischer","Fred Kueffer","Thomas Ryan","Jeroen Bax","Angel Leon"],"significance":5,"published":"2016-02-01","source_date":"2016-02-01","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/af-bij-ouderen/"],"congress":"","summary_en":"This randomized study of peri-infarct zone pacing in patients with large MI tested whether localized electrical stimulation prevents adverse LV remodeling, exploring a novel device-based approach to limit post-infarction heart failure.","created":"2026-07-03T10:25:55Z","updated":"2026-07-03T18:38:21Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde studie bij 126 patiënten met een groot eerste myocardinfarct die onderzocht of pacing in de peri-infarctzône linkerkamerremodellering en klinische uitkomsten kan verbeteren.","abstract_original":"AIMS: We sought to determine whether peri-infarct pacing prevents left ventricular (LV) remodelling and improves functional and clinical outcomes in patients with large first myocardial infarction (MI). METHODS AND RESULTS: A total of 126 patients at 27 international sites within 10 days of onset of anterior or non-anterior MI with creatine phosphokinase >3000 U/L and QRS duration ≤120 ms were randomized 1:1:1 to dual-site biventricular pacing vs. single-site LV only pacing vs. non-implanted control. The primary endpoint was the echocardiographic core laboratory-assessed change in LV end-diastolic volume (ΔLVEDV) from baseline to 18 months between the pooled pacing therapy groups and the control group. ΔLVEDV increased by 15.3 ± 28.6 mL in the control group and by 16.7 ± 30.5 mL in the pooled pacing groups during follow-up (adjusted mean difference (95% CI) = 0.6 (-12.3, 13.5) mL, P = 0.92). There were also no significant between-group differences in the change in LV end-systolic volume or ejection fraction over time. Quality of life, as assessed by the Minnesota Living with Heart Failure (HF) and European Quality of Life-5 Dimension questionnaires and New York Heart Association class, was also similar between groups during 18-month follow-up. Six-minute walk distance improved during follow-up to an equal degree between groups, and there were no significant differences in the 18-month rates of death or HF hospitalization between the pooled pacing therapy vs. control groups (17.4 vs. 21.7% respectively, P = 0.59). CONCLUSIONS: In the present multicentre, randomized trial, peri-infarct pacing did not prevent LV remodelling or improve functional or clinical outcomes during 18-month follow-up in patients with large first MI. CLINICALTRIALSGOV IDENTIFIER: NCT01213251."}