# MORE-CRT MPP: multipoint pacing bij CRT non-responders

*geplaatst 2023-10-05 · 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/euad294 · https://hartvaat.nl/2023/10/05/more-crt-mpp-multipoint-pacing-bij-crt-non-responders/*

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.

## English: Cardiac resynchronization therapy non-responder to responder conversion rate in the MORE-CRT MPP trial.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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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/euad294. Bijgewerkt 2026-07-03T13:29:40Z. 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.