{"id":"2ad3cb057aa1","type":"article","url":"https://hartvaat.nl/2023/10/05/more-crt-mpp-multipoint-pacing-bij-crt-non-responders/","title":"MORE-CRT MPP: multipoint pacing bij CRT non-responders","title_en":"Cardiac resynchronization therapy non-responder to responder conversion rate in the MORE-CRT MPP trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["cardiale-resynchronisatie"],"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/euad294","source_url":"https://doi.org/10.1093/europace/euad294","authors":["Christophe Leclercq","Haran Burri","Peter Paul Delnoy","Christopher A Rinaldi","Johannes Sperzel","Leonardo Calò","Joaquin Fernandez Concha","Antonio Fusco","Faisal Al Samadi","Kwangdeok Lee","Bernard Thibault"],"significance":6,"published":"2023-10-05","source_date":"2023-10-05","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/crt-cardiale-resynchronisatietherapie/"],"congress":"","summary_en":"The MORE-CRT MPP trial evaluated whether multipoint pacing can convert CRT non-responders to responders, testing programmable stimulation optimization as a salvage strategy for patients who fail conventional biventricular pacing.","created":"2026-07-03T10:30:36Z","updated":"2026-07-03T13:29:40Z","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":"De MORE-CRT MPP-trial onderzocht of multipoint pacing CRT non-responders kan converteren naar responders. Het conversiepercentage was bescheiden, wat suggereert dat non-respons op CRT vaker een patiënt- dan een deviceprobleem is.","abstract_original":"AIMS: To assess the impact of MultiPoint™ Pacing (MPP) in cardiac resynchronization therapy (CRT) non-responders after 6 months of standard biventricular pacing (BiVP). METHODS AND RESULTS: The trial enrolled 5850 patients who planned to receive a CRT device. The echocardiography core laboratory assessed CRT response before implant and after 6 months of BiVP; non-response to BiVP was defined as <15% relative reduction in left ventricular end-systolic volume (LVESV). Echocardiographic non-responders were randomized in a 1:1 ratio to receive MPP (541 patients) or continued BiVP (570 patients) for an additional 6 months and evaluated the conversion rate to the echocardiographic response. The characteristics of both groups at randomization were comparable. The percentage of non-responder patients who became responders to CRT therapy was 29.4% in the MPP arm and 30.4% in the BIVP arm (P = 0.743). In patients with ≥30 mm spacing between the two left ventricular pacing sites (MPP-AS), identified during the first phase as a potential beneficial subgroup, no significant difference in the conversion rate was observed. CONCLUSION: Our trial shows that ∼30% of patients, who do not respond to CRT in the first 6 months, experience significant reverse remodelling in the following 6 months. This finding suggests that CRT benefit may be delayed or slowly incremental in a relevant proportion of patients and that the percentage of CRT responders may be higher than what has been described in short-/middle-term studies. MultiPoint™ Pacing does not improve CRT response in non-responders to BiVP, even with MPP-AS."}