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Updates in Cardiac Resynchronization Therapy for Chronic Heart Failure: Review of Multisite Pacing

  • Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise (A Hasan, Section Editor)
  • Published:
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An Erratum to this article was published on 30 August 2017

This article has been updated

Abstract

Purpose of Review

Cardiac resynchronization therapy (CRT) reduces the morbidity and mortality of patients with left ventricular (LV) systolic dysfunction and intra-ventricular conduction delay. However, its clinical outcomes are heterogeneous and not all patients show a beneficial response. Multisite pacing (MSP), by stimulating the myocardium from more than one locations, is a potential therapeutic option in patients requiring CRT. This article provides a current update in the methods and outcomes of MSP, as well as in challenges in this field and opportunities for further research and development.

Recent Findings

MSP can be delivered either with multiple leads or with quadripolar LV leads which can stimulate the LV from two separate sites. Initial results are promising but not always consistent across studies. Larger patient subgroups and longer follow-up duration are required for more conclusive evaluation of MSP.

Summary

Routine use of MSP in clinical practice cannot be advocated at present. In selected patient subgroups, however, MSP could be considered. Newer devices and expanding knowledge are expected to facilitate the more widespread implementation of MSP and the assessment of its effects in the clinical outcomes of CRT.

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Change history

  • 30 August 2017

    An erratum to this article has been published.

References

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Authors and Affiliations

  1. Cardiovascular Department, Guy’s and St Thomas’ NHS Foundation Trust, Lower Ground Floor, South Wing, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK

    Antonios P. Antoniadis, Ben Sieniewicz, Justin Gould, Bradley Porter, Jessica Webb, Simon Claridge, Jonathan M. Behar & Christopher Aldo Rinaldi

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  1. Antonios P. Antoniadis
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  2. Ben Sieniewicz
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  3. Justin Gould
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  6. Simon Claridge
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  7. Jonathan M. Behar
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Correspondence to Antonios P. Antoniadis.

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Conflict of Interest

Antonios P. Antoniadis, Ben Sieniewicz, Bradley Porter, Jessica Webb, Simon Claridge, and Jonathan Behar declare no conflicts of interest.

Christopher Aldo Rinaldi reports grants and personal fees from Abbott, grants and personal fees from Medtronic, grants and personal fees from Livanova, and grants and personal fees from Boston Scientific.

Justin Gould reports grants from St Jude Medical Fellowship Grant.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

The original version of this article was revised: The middle initial “M” of Jonathan Behar was missing. It should have been Jonathan M. Behar.

This article is part of the Topical Collection on Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise

An erratum to this article is available at https://doi.org/10.1007/s11897-017-0359-3.

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Antoniadis, A.P., Sieniewicz, B., Gould, J. et al. Updates in Cardiac Resynchronization Therapy for Chronic Heart Failure: Review of Multisite Pacing. Curr Heart Fail Rep 14, 376–383 (2017). https://doi.org/10.1007/s11897-017-0350-z

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