Radial strain imaging-guided lead placement for improving response to cardiac resynchronization therapy in patients with ischaemic cardiomyopathy: the Raise CRT trial

Michael Glikson, Roy Beinart, Gregory Golovchiner, Alon Bar Sheshet, Moshe Swissa, Munther Bolous, Raphael Rosso, Aharon Medina, Moti Haim, Paul Friedman, Vladimir Khalamaizer, Shlomit Benzvi, Saki Ito, Ilan Goldenberg, Robert Klempfner, Ori Vaturi, Jae K. Oh

    Research output: Contribution to journalArticlepeer-review

    Abstract

    AIMS: To evaluate the benefit of speckle tracking radial strain imaging (STRSI)-guided left ventricular (LV) lead (LVL) positioning in cardiac resynchronization therapy (CRT) in patients (pts) with ischaemic cardiomyopathy with CRT indication. METHODS AND RESULTS: We conducted a prospective randomized controlled trial. Patients were enrolled in nine centres with 2:1 randomization into two groups (guided vs. control). Patients underwent STRSI to identify the optimal LV position from six LV segments at midventricular level. Implantation via STRSI was attempted for recommended segment in the guided group only. Follow-up included echocardiography (6 months) and clinical evaluation (6 and 12 months). The primary endpoint was comparison % reduction in LV end-systolic volume at 6 months with baseline. Secondary endpoints included hospitalizations for heart failure and death, and improvement in additional echocardiographic measurements and quality of life score. A total of 172 patients (115 guided vs. 57 control) were enrolled. In the guided group, 60% of the implanted LV leads were adjudicated to be successfully located at the recommended segment, whereas in the control group 44% reached the best STRSI determined segment. There was no difference between the groups in any of the primary or secondary endpoints at 6 and 12 months. CONCLUSION: Our findings suggest that echo-guided implantation of an LV lead using STRSI does not improve the clinical or echocardiographic response compared with conventional implantation.

    Original languageEnglish
    Pages (from-to)835-844
    Number of pages10
    JournalEuropace
    Volume24
    Issue number5
    DOIs
    StatePublished - 3 May 2022

    Keywords

    • Heart failure
    • Implantation
    • Resynchronization
    • Tissue Doppler imaging

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Physiology (medical)

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