# Multipoint pacing vermindert HF-hospitalisaties en sterfte bij CRT-non-responders

*geplaatst 2025-06-03 · 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/euaf070 · https://hartvaat.nl/2025/06/03/multipoint-pacing-vermindert-hf-hospitalisaties-en-sterfte-bij-crt-non-responder/*

Studie bevestigde dat multipoint pacing de HF-hospitalisaties en mortaliteit vermindert bij CRT-non-responders. MPP is een effectieve upgrade-strategie.

## English: 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.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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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/euaf070. Bijgewerkt 2026-07-03T13:30:40Z. 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.