Evidence map›Paper›PMID 32757086›Full record

Trial reportJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2021

Effect of closed loop stimulation versus accelerometer on outcomes with cardiac resynchronization therapy: the CLASS trial.

Jonathan C Hsu, Douglas Darden, Maylene Alegre, Ulrika Birgersdotter-Green, Gregory K Feld, Kurt S Hoffmayer, Frederick Han, David Krummen, Farshad Raissi, Gordon Ho and 3 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02693262 (Rate Response With CLS Versus Accelerometer and Effect on Both Subjective Symptoms and Objective Outcomes in a Heart Failure Population Implanted With Cardiac Resynchronization With Defibrillator Device), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02693262 nacompletednot on this map

Rate Response With CLS Versus Accelerometer and Effect on Both Subjective Symptoms and Objective Outcomes in a Heart Failure Population Implanted With Cardiac Resynchronization With Defibrillator Device: The CLASS Trial

TypeinterventionalSponsorUniversity of California, San DiegoRan2016 to 2020Enrolled12ConditionsHeart Failure, ICD, Chronotropic IncompetenceArmsCLS Mode on Biotronik CRT-D, Accelerometer Mode on Biotronik CRT-D
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Enhancement of bicycle exercise capacity in patients with chronotropic incompetence through closed-loop stimulation: a randomized crossover trial.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 · 2023
    Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Jonathan C Hsu *Division of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA. Jonathan.Hsu@ucsd.edu.ORCID http://orcid.org/0000-0002-1523-573X
Douglas Darden *Division of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
Maylene AlegreDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
Ulrika Birgersdotter-GreenDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
Gregory K FeldDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
Kurt S HoffmayerDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
Frederick HanDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
David KrummenDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
Farshad RaissiDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
Gordon HoDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
Pam R TaubDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
Marcus A UreyDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
Eric AdlerDivision of Cardiology, Department of Medicine, University of California, San Diego, 9452 Medical Center Dr., La Jolla, CA, 92037, USA.
University of California San Diego · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeChronotropic incompetence (CI) in patients with heart failure is common and associated with impaired exercise intolerance and adverse outcomes. This study sought to determine the effects of closed loop stimulation (CLS) rate-adaptive pacing on functional capacity in patients with heart failure with reduced ejection fraction (HFrEF) and CI implanted with cardiac resynchronization therapy (CRT) devices.

methodsA randomized, blinded, cross-over designed trial enrolled patients with HFrEF and CI implanted with a Biotronik CRT-D to complete a quality of life questionnaire, 6-min walk distance (6MWD), and cardiopulmonary exercise testing after two programmed periods: 1-week period of CLS and 1-week period of standard accelerometer (DDDR).

resultsNine patients (6 males, mean age 71.4 years, 7 with New York Heart Association Class III, mean ejection fraction 39 ± 8%) were enrolled. Quality of life trended higher in CLS as compared to DDDR (550.8 ± 123.9 vs 489.3 ± 164.9, p = 0.06). There were no differences between CLS and DDDR in 6MWD (293.1 ± 90.2 m vs 315.1 ± 95.5 m, p = 0.52), peak heart rate (HR) 110.7 ± 14.7 bpm vs 109.7 bpm ± 14.1, p = 0.67), or peak VO2 (12.3 ± 4.9 ml/kg/min vs 12.9 ± 5.9, p = 0.47). As tests were submaximal as indicated by low respiratory exchange ratios (0.98 ± 0.11 vs 1.0 ± 0.8, p = 0.35), VE/VCO

conclusionsIn patients with HFrEF and CI implanted with a CRT-D, peak HR, peak VO2, and 6MWD were equivalent, while there was a trend toward improved quality of life in CLS as compared to DDDR. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov . Unique identifier: NCT02693262.

Indexed as

Cardiac Resynchronization TherapyHeart FailureAccelerometryAgedFemaleHumansMaleQuality of LifeStroke VolumeChronotropic incompetenceClosed loop stimulationCRTHeart failure

Identifiers

PMID32757086
OpenAlexW3047266028

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.