{"id":3413,"date":"2023-06-19T12:00:56","date_gmt":"2023-06-19T10:00:56","guid":{"rendered":"https:\/\/rythmologie.fr\/index\/?p=3413"},"modified":"2023-06-19T12:00:56","modified_gmt":"2023-06-19T10:00:56","slug":"newsletter-juin-2023-his-purkinje-conduction-system-pacing-optimized-trial-of-cardiac-resynchronization-therapy-versus-biventricular-pacing-a-randomized-controlled-clinical-trial-hot-crt-p-vija","status":"publish","type":"post","link":"https:\/\/rythmologie.fr\/index\/newsletter-juin-2023-his-purkinje-conduction-system-pacing-optimized-trial-of-cardiac-resynchronization-therapy-versus-biventricular-pacing-a-randomized-controlled-clinical-trial-hot-crt-p-vija\/","title":{"rendered":" Newsletter Juin 2023 – His-purkinje ..."},"content":{"rendered":"

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Newsletter Groupe Rythmologie \u2013 Stimulation cardiaque de la SFC<\/h2><\/div>
Juin 2023<\/div><\/div>[vc_empty_space height=”24px”][vc_separator color=”custom” accent_color=”#e42925″][\/vc_column][\/vc_row][vc_row][vc_column]
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His-purkinje conduction system pacing Optimized Trial of Cardiac Resynchronization Therapy versus biventricular pacing: A randomized controlled clinical trial (HOT-CRT) P. VIJAYAARAMAN, P. POKHAREL, F.A. SUBZPOSH<\/h3><\/div>
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Rapport\u00e9 par <\/em>Michel Chauvin – Strasbourg<\/em><\/p>\n

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La stimulation du faisceau de his (HBP) ou la stimulation de la branche gauche (LBBP) sont chacune une alternative \u00e0 la stimulation biventriculaire (BVP).<\/p>\n

But de l\u2019\u00e9tude<\/u><\/strong><\/h3>\n

Le but de cette \u00e9tude est de comparer la faisabilit\u00e9 et l\u2019efficacit\u00e9 clinique de la stimulation de la branche gauche (LBBP) par rapport \u00e0 la stimulation biventriculaire (BVP) chez des patients en insuffisance cardiaque avec FEVG inf\u00e9rieure \u00e0 50% et une indication de CRT de classes I ou II.<\/p>\n

Il s\u2019agit d\u2019une \u00e9tude prospective, randomis\u00e9e 1\/1, en simple aveugle et contr\u00f4l\u00e9e.<\/p>\n

L\u2019\u00e9tude a recrut\u00e9 d\u2019avril 2021 \u00e0 novembre 2022. Le suivi est de 6 mois.<\/p>\n

Objectif 1\u00b0<\/u>\u00a0:<\/strong><\/p>\n

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  • Les modifications de la FEVG \u00e0 6 mois<\/li>\n<\/ul>\n

    Objectif 2\u00b0<\/u>\u00a0:<\/strong><\/p>\n

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    • Les mesures des dur\u00e9es sur l\u2019ECG<\/li>\n
    • La Classe NYHA<\/li>\n
    • Le test de marche de 6mn<\/li>\n
    • La qualit\u00e9 de vie<\/li>\n
    • La largeur de QRS<\/li>\n
    • La r\u00e9ponse \u00e0 la CRT<\/li>\n<\/ul>\n

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      R\u00e9sultats<\/u><\/strong><\/h3>\n

      100 patients ont \u00e9t\u00e9 randomis\u00e9s.<\/p>\n

      Succ\u00e8s d\u2019implantations chez des patients enr\u00f4l\u00e9s pour b\u00e9n\u00e9ficier d\u2019une stimulation du faisceau de His (HOT-CRT)\u00a0: 48\/50 (96%).<\/p>\n

      Succ\u00e8s d\u2019implantations chez des patients enr\u00f4l\u00e9s pour b\u00e9n\u00e9ficier d\u2019une stimulation biventriculaire (BVO-CRT)\u00a0: 41\/50 (82%).<\/p>\n

      Largeur de QRS<\/u><\/strong><\/p>\n

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      • HOT-CRT\u00a0: diminution de 160 +\/- 23 ms \u00e0 138 +\/- 20 ms<\/li>\n
      • BVP-CRT\u00a0: diminution de 161 +\/-31 ms \u00e0 141 +\/- 19 ms<\/li>\n<\/ul>\n

        Dur\u00e9e de la proc\u00e9dure<\/u>\u00a0:<\/strong><\/p>\n

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        • HOT-CRT\u00a0: 119 +\/- 42 mn<\/li>\n
        • BVP\u00a0: 114 +\/- 36 mn<\/li>\n<\/ul>\n

          Seuil \u00e0 l\u2019implantation :<\/u><\/strong><\/p>\n

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          • HBP\u00a0: 1V<\/li>\n
          • LBBP\u00a0: 0.7 V<\/li>\n
          • CS\u00a0(voie du sinus coronaire): 1.1 V<\/li>\n<\/ul>\n

            Seuil \u00e0 3 mois\u00a0: <\/u><\/strong><\/p>\n

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            • HBP\u00a0: 1.4 V<\/li>\n
            • LBBP\u00a0: 0.6 V<\/li>\n
            • CS\u00a0: 1.2 V<\/li>\n<\/ul>\n

              5 d\u00e9placements de sondes<\/u>\u00a0:<\/strong><\/p>\n

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              • Dans l\u2019OD\u00a0: 2<\/li>\n
              • Dans le VD\u00a0: 1<\/li>\n
              • Au niveau de la branche gauche (LBBP)\u00a0: 1<\/li>\n
              • Au niveau du CS\u00a0: 1<\/li>\n<\/ul>\n

                Conclusion<\/u><\/strong><\/h3>\n

                HOT-CRT semble mieux am\u00e9liorer la FEVG que BVP.<\/p>\n

                Commentaire<\/u>\u00a0:<\/strong> Il est n\u00e9cessaire d\u2019entreprendre des \u00e9tudes \u00e0 plus large \u00e9chelle et de plus longue dur\u00e9e.<\/p>\n

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                [\/vc_column_text][vc_empty_space height=”24px”][vc_empty_space height=”24px”][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space][vc_empty_space][vc_separator][vc_empty_space][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"

                [vc_row][vc_column css=”.vc_custom_1663235123898{margin-top: 0px !important;border-top-width: 0px !important;background-color: rgba(255,255,255,0.1) !important;*background-color: rgb(255,255,255) !important;}”][vc_empty_space height=”24px”][vc_separator color=”custom” accent_color=”#e42925″][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space height=”24px”][vc_column_text] La stimulation du faisceau de his (HBP) ou la stimulation de la branche gauche (LBBP) sont chacune une alternative \u00e0 la stimulation biventriculaire (BVP). But de l\u2019\u00e9tude Le but de cette \u00e9tude est de comparer la faisabilit\u00e9 et l\u2019efficacit\u00e9 clinique de…<\/p>\n","protected":false},"author":2,"featured_media":3415,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[31,22],"tags":[],"class_list":["post-3413","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-newsletter","category-articles","category-31","category-22","description-off"],"_links":{"self":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/3413","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/comments?post=3413"}],"version-history":[{"count":2,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/3413\/revisions"}],"predecessor-version":[{"id":3417,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/3413\/revisions\/3417"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media\/3415"}],"wp:attachment":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media?parent=3413"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/categories?post=3413"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/tags?post=3413"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}