Cardiac resynchronisation therapy in patients with heart failure and a normal QRS duration: the RESPOND study

Paul W X Foley, Kiran Patel, Nick Irwin, John E Sanderson, Michael P Frenneaux, Russell E A Smith, Berthold Stegemann, Francisco Leyva

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

OBJECTIVES: To evaluate the clinical response to cardiac resynchronisation therapy (CRT) in patients with heart failure and a normal QRS duration (<120 ms).

SETTING: Single centre.

PATIENTS: 60 patients with heart failure and a normal QRS duration receiving optimal pharmacological treatment (OPT).

INTERVENTIONS: Patients were randomly assigned to CRT (n=29) or to a control group (OPT, n=31). Cardiovascular magnetic resonance was used in order to avoid scar at the site of left ventricular (LV) lead deployment.

MAIN OUTCOME MEASURES: The primary end point was a change in 6 min walking distance (6-MWD). Other measures included a change in quality of life scores (Minnesota Living with Heart Failure questionnaire) and New York Heart Association class.

RESULTS: In 93% of implantations, the LV lead was deployed over non-scarred myocardium. At 6 months, the 6-MWD increased with CRT compared with OPT (p<0.0001), with more patients reaching a =25% increase (51.7% vs 12.9%, p=0.0019). Compared with OPT, CRT led to an improvement in quality-of-life scores (p=0.0265) and a reduction in NYHA class (p<0.0001). The composite clinical score (survival for 6 months free of heart failure hospitalisations plus improvement by one or more NYHA class or by =25% in 6-MWD) was better in CRT than in OPT (83% vs 23%, respectively; p<0.0001). Although no differences in total or cardiovascular mortality emerged between OPT and CRT, patients receiving OPT had a higher risk of death from pump failure than patients assigned to CRT (HR=8.41, p=0.0447) after a median follow-up of 677.5 days.

CONCLUSIONS: CRT leads to an improvement in symptoms, exercise capacity and quality of life in patients with heart failure and a normal QRS duration. (ClinicalTrials.gov number, NCT00480051.).
Original languageEnglish
Pages (from-to)1041-1047
Number of pages7
JournalHeart
Volume97
Issue number13
Early online date21 Feb 2011
DOIs
Publication statusPublished - Jul 2011

Keywords

  • adult
  • aged
  • aged, 80 and over
  • cardiac resynchronization therapy
  • electrocardiography
  • epidemiologic methods
  • exercise test
  • female
  • heart failure
  • humans
  • male
  • middle aged
  • pacemaker, artificial
  • quality of life
  • treatment outcome
  • walking

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  • Cite this

    Foley, P. W. X., Patel, K., Irwin, N., Sanderson, J. E., Frenneaux, M. P., Smith, R. E. A., Stegemann, B., & Leyva, F. (2011). Cardiac resynchronisation therapy in patients with heart failure and a normal QRS duration: the RESPOND study. Heart, 97(13), 1041-1047. https://doi.org/10.1136/hrt.2010.208355