Long-term benefits of biventricular pacing in congestive heart failure: results from the MUltisite STimulation in cardiomyopathy (MUSTIC) study.
OBJECTIVE
The main objective of this study was to assess if the benefits of biventricular (BiV) pacing observed during the crossover phase were sustained over 12 months.


BACKGROUND
MUltisite STimulation In Cardiomyopathies (MUSTIC) is a randomized controlled study intended to evaluate the effects of BiV pacing in patients with New York Heart Association (NYHA) class III heart failure and intraventricular conduction delay.


METHODS
Of 131 patients included, 42/67 in sinus rhythm (SR) and 33/64 in atrial fibrillation (AF) were followed up longitudinally at 9 and 12 months by 6-min walked distance, peak oxygen uptake (peak VO(2)), quality of life by the Minnesota score, NYHA class, echocardiography, and left ventricular ejection fraction by radionuclide technique.


RESULTS
At 12 months, all SR and 88% of AF patients were programmed to BiV pacing. Compared with baseline, the 6-min walked distance increased by 20% (SR) (p = 0.0001) and 17% (AF) (p = 0.004); the peak VO(2) by 11% (SR) and 9% (AF); quality of life improved by 36% (SR) (p = 0.0001) and 32% (AF) (p = 0.002); NYHA class improved by 25% (SR) (p = 0.0001) and 27% (AF) (p = 0.0001). The ejection fraction improved by 5% (SR) and 4% (AF). Mitral regurgitation decreased by 45% (SR) and 50% (AF).


CONCLUSIONS
The clinical benefits of BiV pacing appeared to be significantly maintained over a 12-month follow-up period.
Linde
Cecilia
C
Department of Cardiology, Karolinska Hospital, Stockholm, Sweden. cecilia.linde@ks.se
Leclercq
Christophe
C
Rex
Steve
S
Garrigue
Stephane
S
Lavergne
Thomas
T
Cazeau
Serge
S
McKenna
William
W
Fitzgerald
Melissa
M
Deharo
Jean-Claude
JC
Alonso
Christine
C
Walker
Stuart
S
Braunschweig
Frieder
F
Bailleul
Christophe
C
Daubert
Jean-Claude
JC
D000368:Aged; D001281:Atrial Fibrillation / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D016022:Case-Control Studies; D018592:Cross-Over Studies; D004562:Electrocardiography; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011788:Quality of Life; D016037:Single-Blind Method; D013997:Time Factors