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AXA
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Go further with international health insurance. Global support for people who think a little bigger
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The Apollonion Private Hospital is an ultra-modern Hospital purposely built to offer the best medical care to its patients.
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Durbin
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Specialist medical suppliers in sourcing and distributing pharmaceuticals, medical equipment and consumable supplies.
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Self
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Women Magazine on Fitness, Health, Food, Beauty & more.
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Easyway
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Allen Carr Easyway International operates clinics in more than 150 cities in over 50 countries worldwide.
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id Hospital
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All kinds of plastic surgeries at affordable cost.
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Al Zahra Hospital
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Al Zahra Hospital Sharjah is the first and the largest private general hospital in the UAE with both inpatient and outpatient treatment at an international standard,
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Kunming Children�s Hospital
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Kunming Children Hospital integrates first aid, medical treatment, rehabilitation, health care, & scientific research.
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UT Health
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UT Health East Texas is passionate about delivering the highest quality care with unmatched compassion, outstanding service and innovative technology.
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<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Aims</div>A dual-chamber leadless pacemaker (LP) system that employs distinct atrial and ventricular LP devices (ALP, VLP) has been introduced to clinical practice. Proprietary, low-energy, implant-to-implant (i2i) communication at each beat enables the devices to maintain synchronous atrioventricular sensing and pacing. We evaluated device longevities and contributing factors, such as i2i communication.<div class="boxTitle">Methods and results</div>Patients meeting dual-chamber pacing indications received the dual-chamber LP system as part of a prospective, multi-centre, international clinical trial (Aveir DR i2i Study, NCT05252702). Programming and diagnostics were interrogated from all <span style="font-style:italic;">de novo</span>, non-revised, dual-chamber programmed devices at 12 months post-implant. This analysis included 302 patients (65% male; age 70 ± 13 years; weight 80 ± 19 kg; intrinsic heart rate 55 ± 7 bpm; 58% sinus node dysfunction, 27% atrioventricular block). At 12 months, devices were programmed to dual-chamber pacing (DDD(R) or DDI(R)) at a median 60 bpm rate, median 1.25 V pulse amplitude in ALP and 1.5 V in VLP, median 0.4 ms pulse width, and median i2i signal setting level 5 out of 7. Median ALP and VLP remaining battery longevities at 12 months were 4.3 and 9.1 years, with median total ALP and VLP longevities of 5.3 and 9.9 years. Base rate, pulse amplitude, pacing percentage, event rate, impedance, and i2i setting level all exhibited significant correlations with ALP and VLP longevities (<span style="font-style:italic;">P</span> < 0.001). Programming i2i setting levels below 7 produced the greatest longevity savings.<div class="boxTitle">Conclusion</div>The first dual-chamber LP demonstrated adequate projected battery longevity after 12 months of use. Patient-specific device programming considerations, unique to leadless devices, may extend longevity.</span>
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Aims</div>Cardiac resynchronization therapy (CRT) via biventricular pacing (BIVP) is an effective treatment, but non-responders are at a higher risk of death and heart failure (HF) hospitalizations compared with CRT responders. The MORE-CRT MPP trial aimed to evaluate whether CRT with multipoint pacing (MPP) is associated with improved clinical outcomes in CRT non-responders.<div class="boxTitle">Methods and results</div>Cardiac resynchronization therapy patients were treated with conventional BIVP for 6 months and then assessed for CRT response (left ventricular end-systolic volume relative reduction >15% vs. baseline). Cardiac resynchronization therapy non-responders were 1:1 randomized to BIVP or MPP and followed for 6 months. The main endpoint of this secondary analysis was HF hospitalizations or all-cause mortality. Of 3724 CRT patients (67 ± 11 years, 1050 female), 1677 were non-responders and randomized to MPP or BIVP, of whom 1421 (722 MPP and 699 BIVP) had complete data. In a mean follow-up of 5 ± 1 months after randomization, MPP was associated with a lower incidence of HF hospitalizations or all-cause mortality [48/722 (6.64%)] compared with BIVP (73/699 (10.44%), RRR = 36% (95% CI=±4%), <span style="font-style:italic;">P</span> = 0.0107). At multivariable analysis, MPP was associated with a lower occurrence of the main endpoint (odds ratio = 0.60, <span style="font-style:italic;">P</span> = 0.0124). At logistic regression analysis, HF hospitalizations or all-cause death were lower with MPP vs. BIVP in the whole population and in many patients subgroups, e.g. ischaemic patients and patients with long (>105 ms) interventricular electrical delay.<div class="boxTitle">Conclusion</div>In the MORE-CRT MPP randomized trial, MPP was associated with a significant reduction of all-cause mortality and HF hospitalizations in prior non-responders to conventional biventricular pacing.</span>
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