Trial reportClinical research in cardiology : official journal of the German Cardiac Society2016
Sustained clinical benefit of cardiac resynchronization therapy in non-LBBB patients with prolonged PR-interval: MADIT-CRT long-term follow-up.
Trial report in Clinical research in cardiology : official journal of the German Cardiac Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Pacemaker and Atrioventricular Junction Ablation in Patients With Atrial Fibrillation-A Systematic Review of Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2021Pooled it
- Effects of haemodynamically atrio-ventricular optimized His bundle pacing on heart failure symptoms and exercise capacity: the His Optimized Pacing Evaluated for Heart Failure (HOPE-HF) randomized, double-blind, cross-over trial.European journal of heart failure · 2023Trial
- Cardiac implantable electronic devices in heart failure: needs, challenges, and real-world implementation.Heart failure reviews · 2026Review
- The Atrioventricular Coupling in Heart Failure: Pathophysiological and Therapeutic Aspects.Reviews in cardiovascular medicine · 2024Review
- Potential Underestimation of Left Ventricular Mechanical Dyssynchrony in Dyssynchrony and Outcomes Assessment.Journal of multidisciplinary healthcare · 2024Article
- Frontiers in conduction system pacing: treatment of long PR in patients with heart failure.European heart journal supplements : journal of the European Society of Cardiology · 2023Article
- Can we correct dyssynchrony by pacing the right side? The case for right ventricular-synchronized cardiac resynchronization therapy.HeartRhythm case reports · 2023Article
- Value of frontal QRS axis for risk stratification of individuals with prolonged PR interval.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2023Article
- Echocardiographic Evaluation of His Bundle Pacing in Patients with Prolonged PR Intervals.Cardiology and cardiovascular medicine · 2023Article
- Pacing therapy for atrioventricular dromotropathy: a combined computational-experimental-clinical study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2022Article
- Determinants of Response to Cardiac Resynchronization Therapy.The Journal of innovations in cardiac rhythm management · 2022Article
- Shortening of time-to-peak left ventricular pressure rise (Td) in cardiac resynchronization therapy.ESC heart failure · 2021Observational
- A Simple Predictive Marker in Cardiac Resynchronization Therapy Recipients: Prominent S-Wave in Right Precordial Leads.Medicina (Kaunas, Lithuania) · 2021Article
- The Emerging Role of Cardiac Conduction System Pacing as a Treatment for Heart Failure.Current heart failure reports · 2020Review
- PR Prolongation predicts inadequate resynchronization with biventricular pacing in left bundle branch block.Pacing and clinical electrophysiology : PACE · 2019Article
- Geographical distribution of the P-R interval reference value of Chinese healthy adults.International journal of biometeorology · 2019Article
- Prolonged PR Interval and Outcome in Cardiac Resynchronization Therapy.Arquivos brasileiros de cardiologia · 2019Article
- ICD lead type and RV lead position in CRT-D recipients.Clinical research in cardiology : official journal of the German Cardiac Society · 2018Article
- Rationale and design for ENHANCE CRT: QLV implant strategy for non-left bundle branch block patients.ESC heart failure · 2018Article
- Rationale and design of the randomized multicentre His Optimized Pacing Evaluated for Heart Failure (HOPE-HF) trial.ESC heart failure · 2018Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn MADIT-CRT, patients with non-LBBB (right bundle branch block or nonspecific ventricular conduction delay) and a prolonged PR-interval derived significant clinical benefit from cardiac resynchronization therapy with defibrillator (CRT-D) compared to an implantable cardioverter defibrillator (ICD)-only. We aimed to study the long-term outcome of non-LBBB patients by baseline PR-interval with CRT-D versus ICD-only.
methodsNon-LBBB patients (n = 534) were dichotomized based on baseline PR-interval: normal PR (PR < 230 ms), and markedly prolonged PR (PR ≥ 230 ms). The primary end point was heart failure (HF) or death. Secondary end points were HF only and all-cause death.
resultsIn patients with a prolonged PR-interval, CRT-D treatment related to a 67 % significant reduction in the risk of HF/death (HR = 0.33, 95 % CI 0.16-0.69, p = 0.003), 69 % decrease in HF (HR = 0.31, 95 % CI 0.14-0.68, p = 0.003), and 76 % reduction in the risk of death (HR = 0.24, 95 % CI 0.07-0.80, p = 0.020) compared to ICD-only (median follow-up 5.8 years). In normal PR-interval patients, CRT-D therapy was associated with a trend towards increased risk of HF/death (HR = 1.49, 95 % CI 0.98-2.25, p = 0.061), and significantly increased mortality (HR = 2.27, 95 % CI 1.16-4.44, p = 0.014). Significant statistical interaction with the PR-interval was demonstrated for all end points. Results were consistent for QRS 130-150 ms and QRS > 150 ms.
conclusionIn MADIT-CRT, non-LBBB patients with a prolonged PR-interval derive sustained long-term clinical benefit with reductions in heart failure or death from CRT-D implantation, compared to an ICD-only. Our findings support implantation of CRT-D in non-LBBB patients with prolonged PR-interval irrespective of baseline QRS duration.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.