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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction

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DOI

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  • Gregg W Stone
  • Eugene S Chung
  • Branislav Stancak
  • Jesper H Svendsen
  • Trent M Fischer
  • Fred Kueffer
  • Thomas Ryan
  • Jeroen Bax
  • Angel Leon
  • PRomPT Trial Investigators
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AIMS: We sought to determine whether peri-infarct pacing prevents left ventricular (LV) remodelling and improves functional and clinical outcomes in patients with large first myocardial infarction (MI).

METHODS AND RESULTS: A total of 126 patients at 27 international sites within 10 days of onset of anterior or non-anterior MI with creatine phosphokinase >3000 U/L and QRS duration ≤120 ms were randomized 1:1:1 to dual-site biventricular pacing vs. single-site LV only pacing vs. non-implanted control. The primary endpoint was the echocardiographic core laboratory-assessed change in LV end-diastolic volume (ΔLVEDV) from baseline to 18 months between the pooled pacing therapy groups and the control group. ΔLVEDV increased by 15.3 ± 28.6 mL in the control group and by 16.7 ± 30.5 mL in the pooled pacing groups during follow-up (adjusted mean difference (95% CI) = 0.6 (-12.3, 13.5) mL, P = 0.92). There were also no significant between-group differences in the change in LV end-systolic volume or ejection fraction over time. Quality of life, as assessed by the Minnesota Living with Heart Failure (HF) and European Quality of Life-5 Dimension questionnaires and New York Heart Association class, was also similar between groups during 18-month follow-up. Six-minute walk distance improved during follow-up to an equal degree between groups, and there were no significant differences in the 18-month rates of death or HF hospitalization between the pooled pacing therapy vs. control groups (17.4 vs. 21.7% respectively, P = 0.59).

CONCLUSIONS: In the present multicentre, randomized trial, peri-infarct pacing did not prevent LV remodelling or improve functional or clinical outcomes during 18-month follow-up in patients with large first MI.

CLINICALTRIALSGOV IDENTIFIER: NCT01213251.

Original languageEnglish
JournalEuropean Heart Journal
Volume37
Issue number5
Pages (from-to)484-93
Number of pages10
ISSN0195-668X
DOIs
StatePublished - 1 Feb 2016

    Research areas

  • Journal Article, Research Support, Non-U.S. Gov't

ID: 49126274