https://doi.org/10.55788/34758824
The CRT-DRIVE study (NCT05327062) is a controlled, multicentre study investigating the feasibility of pre-interventional guidance of CRT by non-invasive electrical and venous anatomy assessment, to allow for patient-tailored implantation [1]. The system integrates 3D images of a 3D activation sequence from an electrocardiogram and the coronary venous anatomy from cardiac computerised tomography. The resulting CRT roadmap guides left ventricular (LV) lead placement to a coronary vein in an electrically late-activated region.
“Our system enhances the precision of the interventions,” said Dr Mikhail Chmelevsky (Cardiocentro Ticino Institute, Switzerland). “It is a unique workflow that integrates seamlessly into existing clinical processes without disruption.” He stressed the importance of the system's fast data-processing capabilities, which ensure that results and images are available at the time of implantation, thus informing decision-making. The 3D visualisation of ventricular electrical activation during CRT programming improves the quality of the procedure, observed Dr Chmelevsky, but it also gives a unique opportunity for effective follow-up.
CRT-DRIVE aims to include 150 participants, said Dr Chmelevsky; thus far, 25 participants have been included, and the results of the first 9 were presented. After 6 months, the results of 9 participants showed that non-invasive mapping was associated with a significant reduction in LV end-systolic volume and a significant increase in LV ejection fraction (P=0.008 for both).
Dr Chmelevsky added that many aspects still require further clarification, such as the procedure's reliability, reproducibility, accessibility, and affordability, as well as the strength of the efficacy endpoints used. Further larger scale studies are needed to assess the efficacy of the non-invasive mapping system.
- Chmelevsky M, et al. Cardiac resynchronization therapy delivery guided by non-invasive electrical and venous anatomy assessment (CRT-DRIVE) clinical trial. Late breaking clinical trials: devices, Heart Failure 2024, 11–14 May, Lisbon, Portugal.
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Table of Contents: HFA 2024
Featured articles
Meet the Trialist: Innovating cardiac monitoring with MONITOR-HF
Trials: Pharmacology
Effects of semaglutide on MACE irrespective of HF status
SEQUOIA-HCM: Aficamten demonstrates clinical efficacy in obstructive HCM
ARIES-HM3 trial: Subgroup analysis in patients with prior need for aspirin
Three diuretic regimens compared in the DEA-HF study
Adding a mineralocorticoid receptor modulator in heart failure with CKD
SGLT2 Inhibitors
Empagliflozin did not reduce mortality for HF after MI regardless of T2D status
SGLT2 inhibitors decrease atrial fibrillation risk in patients with HFrEF
SGLT2 inhibition: Major and early impact on heart failure hospitalisation risk
Trials: Other
Individualised diuretic titration in acute HF without a physician
Intravenous iron deficiency treatment improves exercise capacity in patients with HFpEF
CD34+ stem cells promote reverse cardiac remodelling after acute MI
Registries
Sex-specific outcomes and resource utilisation after HF hospitalisation
Application of guideline-directed medical therapy in patients with HFrEF in the Netherlands
Devices
PAP-guided management system appears safe in patients with HF
Delivery of CRT guided by non-invasive anatomy assessment
RELIEVE-ing HFrEF with interatrial shunting
Miscellaneous
Algorithm-based remote patient monitoring was associated with lower mortality in a retrospective cohort study
High mortality and morbidity in suspected de novo HF in outpatient care
Bio-ADM as a marker for congestion in patients hospitalised for acute HF
Hypertonic saline not effective in ambulatory patients with heart failure?
No effect of low-dose carperitide on mortality or hospitalisation in acute HF
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