{"id":"837d994f103e","type":"article","url":"https://hartvaat.nl/2022/05/03/multimodaliteitsbeeldvorming-geleide-lv-leadplaatsing-bij-crt-langetermijn/","title":"Multimodaliteitsbeeldvorming-geleide LV-leadplaatsing bij CRT: langetermijn","title_en":"Long-term outcomes in a randomized controlled trial of multimodality imaging-guided left ventricular lead placement in cardiac resynchronization therapy.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euab314","source_url":"https://doi.org/10.1093/europace/euab314","authors":["Daniel Benjamin Fyenbo","Anders Sommer","Bjarne Linde Nørgaard","Mads Brix Kronborg","Jens Kristensen","Christian Gerdes","Henrik Kjærulf Jensen","Jesper Møller Jensen","Jens Cosedis Nielsen"],"significance":5,"published":"2022-05-03","source_date":"2022-05-03","image":"","kennis":[],"congress":"","summary_en":"This trial reported long-term outcomes of multimodality imaging-guided LV lead placement for CRT, showing that combining imaging techniques for optimal lead positioning reduces heart failure events over extended follow-up.","created":"2026-07-03T10:29:44Z","updated":"2026-07-03T13:28:51Z","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":"Langetermijnresultaten van een gerandomiseerde trial van multimodaliteitsbeeldvorming-geleide LV-leadplaatsing bij CRT.","abstract_original":"AIMS: This study aims to investigate the long-term occurrence of the composite endpoint of heart failure (HF) hospitalization or all-cause death (primary endpoint) in patients randomized to cardiac resynchronization therapy (CRT) using individualized multimodality imaging-guided left ventricular (LV) lead placement compared with a routine fluoroscopic approach. Furthermore, this study aims to evaluate whether inter-lead electrical delay (IED) is associated with improved response rate of this endpoint. METHODS AND RESULTS: We reviewed follow-up data until November 2020 for all 182 patients included in the ImagingCRT trial for the occurrence of HF hospitalization and all-cause death. During median (inter-quartile range) time to primary endpoint/censuring of 6.7 (3.3-7.9) years, the rate of the primary endpoint was 60% (n = 53) in the imaging group compared with 52% (n = 48) in the control group [hazard ratio (HR) 1.22, 95% confidence interval (CI) 0.83-1.81, P = 0.31]. Neither the risk of HF hospitalization (HR 1.11, 95% CI 0.62-1.99, P = 0.72) nor of all-cause death differed between treatment groups (HR 1.23, 95% CI 0.82-1.85, P = 0.32). The risk of the primary endpoint was significantly reduced among those with IED ≥100 ms when compared with those with IED <100 ms (HR 0.62, 95% CI 0.39-0.98, P = 0.04). CONCLUSIONS: In this study, an individualized multimodality imaging-guided strategy targeting LV lead placement towards the latest mechanically activated non-scarred myocardial segment during CRT implantation did not reduce HF hospitalization or all-cause death when compared with routine LV lead placement during long-term follow-up. Targeting the latest electrical activation should be studied as an alternative individualized strategy for optimizing LV lead placement in CRT recipients."}