@article{382cfd7aed8d49d0a1d8f40d12bb339f,
title = "Electrocardiogram Belt Guidance for Left Ventricular Lead Placement and Biventricular Pacing Optimization",
abstract = "Background: Patients with ischemic cardiomyopathy, non–left bundle branch block, or QRS duration <150 ms have a lower response rate to cardiac resynchronization therapy (CRT) than did other indicated patients. The ECG Belt system (EBS) is a novel surface mapping system designed to measure electrical dyssynchrony via the standard deviation of the activation times of the left ventricle. Objectives: The objectives of this study were to evaluate the efficacy of the EBS in patients less likely to respond to CRT and to determine whether EBS use in lead placement guidance and device programming was superior to standard CRT care. Methods: This was a prospective randomized trial of patients with heart failure and EBS-guided CRT implantation and programming vs standard CRT care. The primary end point was relative change in left ventricular end-systolic volume from baseline to 6 months postimplantation. Results: A total of 408 patients from centers in Europe and North America were randomized. Although both patients with EBS and control patients had a mean improvement in left ventricular end-systolic volume, there was no significant difference in relative change from baseline (P = .26). While patients with a higher baseline standard deviation of the activation times derived greater left ventricular reverse remodeling, improvement in electrical dyssynchrony did not correlate with the extent of reverse remodeling. Conclusion: The findings of the present study do not support EBS - guided therapy for CRT management of heart failure with reduced ejection fraction.",
author = "John Rickard and Kevin Jackson and Michael Gold and Mauro Biffi and Matteo Ziacchi and Joshua Silverstein and Brian Ramza and Mark Metzl and Eric Grubman and Richard Abben and Niraj Varma and Ghiyath Tabbal and Cory Jensen and Griet Wouters and Subham Ghosh and Kevin Vernooy and {ECG Belt for CRT Response Study Group}",
note = "Funding Information: Disclosures: Dr Rickard reports consulting fees from Medtronic and speaking fees and research funding from Abbott. Dr Jackson serves as a consultant for Medtronic. Dr Gold serves as a consultant and performs clinical trials for Boston Scientific, EBR Systems and Medtronic and performs clinical trials for Abbott. Dr Biffi reports educational activity and speaker bureau from Boston Scientific, Biotronik, Medtronic, and Zoll. Dr Ziacchi reports speaker fees from Biotronik, Boston Scientific, and Abbott. Dr Silverstein serves as a consultant for Medtronic and Biosense Webster. Dr Metzl serves as a consultant from Abbott, Biosense Webster, Medtronic, Philips, and Zoll. Dr Abben serves as a consultant for Medtronic. NV serves as a researcher/principal investigator/study coordinator member/consultant for Abbott, Biotronik, Boston Scientific, EP Solutions, Medtronic, Impulse Dynamics, Implicity, PaceMate, and Cardiologs. Mr Jensen, Ms Wouters, and Dr Ghosh are employees and shareholders of Medtronic. Dr Vernooy serves as a consultant for Medtronic, Boston Scientific, Philips, Biosense Webster, and Abbott. Drs Ramza, Grubman, and Tabbal have no conflicts to disclose. Funding Information: Funding Sources: This work was supported by the ECG Belt for CRT Response trial ( ClinicalTrials.gov identifier NCT03504020 ), which was funded by Medtronic Corporation. Publisher Copyright: {\textcopyright} 2022 Heart Rhythm Society",
year = "2023",
month = apr,
doi = "10.1016/j.hrthm.2022.11.015",
language = "English",
volume = "20",
pages = "537--544",
journal = "Heart Rhythm",
issn = "1547-5271",
publisher = "Elsevier Science",
number = "4",
}