# Multimodaliteitsbeeldvorming-geleide LV-leadplaatsing bij CRT: langetermijn

*geplaatst 2022-05-03 · Hartfalen · 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 · https://hartvaat.nl/2022/05/03/multimodaliteitsbeeldvorming-geleide-lv-leadplaatsing-bij-crt-langetermijn/*

Langetermijnresultaten van een gerandomiseerde trial van multimodaliteitsbeeldvorming-geleide LV-leadplaatsing bij CRT.

## English: Long-term outcomes in a randomized controlled trial of multimodality imaging-guided left ventricular lead placement in cardiac resynchronization therapy.

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.

## Abstract (original, from the publication)

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.

Auteurs: Daniel Benjamin Fyenbo, Anders Sommer, Bjarne Linde Nørgaard, Mads Brix Kronborg, Jens Kristensen, Christian Gerdes, Henrik Kjærulf Jensen, Jesper Møller Jensen, Jens Cosedis Nielsen

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Bron: 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, https://doi.org/10.1093/europace/euab314. Bijgewerkt 2026-07-03T13:28:51Z. 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.