{"id":"7a1ef26ba7cf","type":"article","url":"https://hartvaat.nl/2025/06/03/multipoint-pacing-vermindert-hf-hospitalisaties-en-sterfte-bij-crt-non-responder/","title":"Multipoint pacing vermindert HF-hospitalisaties en sterfte bij CRT-non-responders","title_en":"Multipoint pacing is associated with reduction of heart failure hospitalizations or death in patients who do not respond to cardiac resynchronization therapy: results of the MORE-CRT MPP randomized 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/euaf070","source_url":"https://doi.org/10.1093/europace/euaf070","authors":["Christophe Leclercq","Haran Burri","Leonardo Calò","Christopher Aldo Rinaldi","Johannes Sperzel","Bernard Thibault","Tim Betts","Pascal Defaye","Andreas Hain","Olivier Piot","Kwangdeok Lee","Wenjiao Lin","Annalisa Pollastrelli","Andrea Grammatico","Giuseppe Boriani"],"significance":6,"published":"2025-06-03","source_date":"2025-06-03","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/crt-cardiale-resynchronisatietherapie/"],"congress":"","summary_en":"This study confirmed that multipoint pacing reduces heart failure hospitalization and death in CRT non-responders, establishing MPP as a rescue strategy for patients who fail to improve with conventional biventricular stimulation.","created":"2026-07-03T10:31:40Z","updated":"2026-07-03T13:30:40Z","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":"Studie bevestigde dat multipoint pacing de HF-hospitalisaties en mortaliteit vermindert bij CRT-non-responders. MPP is een effectieve upgrade-strategie.","abstract_original":"AIMS: Cardiac resynchronization therapy (CRT) via biventricular pacing (BIVP) is an effective treatment, but non-responders are at a higher risk of death and heart failure (HF) hospitalizations compared with CRT responders. The MORE-CRT MPP trial aimed to evaluate whether CRT with multipoint pacing (MPP) is associated with improved clinical outcomes in CRT non-responders. METHODS AND RESULTS: Cardiac resynchronization therapy patients were treated with conventional BIVP for 6 months and then assessed for CRT response (left ventricular end-systolic volume relative reduction >15% vs. baseline). Cardiac resynchronization therapy non-responders were 1:1 randomized to BIVP or MPP and followed for 6 months. The main endpoint of this secondary analysis was HF hospitalizations or all-cause mortality. Of 3724 CRT patients (67 ± 11 years, 1050 female), 1677 were non-responders and randomized to MPP or BIVP, of whom 1421 (722 MPP and 699 BIVP) had complete data. In a mean follow-up of 5 ± 1 months after randomization, MPP was associated with a lower incidence of HF hospitalizations or all-cause mortality [48/722 (6.64%)] compared with BIVP (73/699 (10.44%), RRR = 36% (95% CI=±4%), P = 0.0107). At multivariable analysis, MPP was associated with a lower occurrence of the main endpoint (odds ratio = 0.60, P = 0.0124). At logistic regression analysis, HF hospitalizations or all-cause death were lower with MPP vs. BIVP in the whole population and in many patients subgroups, e.g. ischaemic patients and patients with long (>105 ms) interventricular electrical delay. CONCLUSION: In the MORE-CRT MPP randomized trial, MPP was associated with a significant reduction of all-cause mortality and HF hospitalizations in prior non-responders to conventional biventricular pacing."}