Clinical study
Long-term benefits of biventricular pacing in congestive heart failure: results from the MUltisite STimulation in cardiomyopathy (MUSTIC) study

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Abstract

Objectives

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 VO2), 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 VO2by 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.

Abbreviations

ACE
angiotensin-converting enzyme
AF
atrial fibrillation
AV
atrioventricular
BiV
biventricular
BP
blood pressure
CT
cardiothoracic
HF
heart failure
HR
heart rate
LV
left ventricle/ventricular
MUSTIC
MUltisite STimulation In Cardiomyopathies
NYHA
New York Heart Association
RV
right ventricle/ventricular
SR
sinus rhythm
VVIR
rate adaptive ventricular inhibited pacing

Cited by (0)

Supported by ELA Recherche, Medtronic, the Swedish Heart and Lung Association and the Swedish Medical Research Council (grant no. B96-11626-01). During the study Drs. Cazeau and Daubert were paid consultants of Medtronic, and Dr. Cazeau was also a paid consultant of ELA Recherche. Dr. Bailleul is an employee of ELA Recherche.