Heart failure & cardiomyopathies
Effects of Atrioventricular Optimization on Left Ventricular Reverse Remodeling With Cardiac Resynchronization Therapy: Results of the SMART-CRT Trial
Authors' conclusion
Analysis of reverse remodeling parameters demonstrated that AVO via SmartDelay, relative to the nonoptimized fixed atrioventricular delay comparator group, improved absolute and relative changes in LV function in patients with longer right ventricular-LV duration.
Study context
- Population
- De novo CRT implant patients with RV-LV duration ≥70 ms120 women
- Participants
- 310 patients
- Comparison
- AV optimization algorithm (SmartDelay) vs fixed AV delay of 120 ms with biventricular pacing
- Primary endpoint
- Echocardiographic CRT response (>15% reduction in LV end-systolic volume)
- Follow-up
- 6 months
Methodological detailsglobal, multicentre, prospective, 1:1 randomisation
- Global
- Multicentre
- Prospective
- 1:1 randomisation
Primary result
As reported in the abstract
P = 0.17
Secondary outcomes
Relative improvement in LVEF
P = 0.050
| Outcome | SmartDelay | Fixed | P value |
|---|---|---|---|
| Absolute change in LV end-systolic volume (prespecified secondary)Median, mL | −41.0 | −33.0 | P = 0.01 |
| Relative change in LV end-systolic volume (prespecified secondary) | −38.3% | −27.8% | P = 0.03 |
Absolute improvement in LVEF
- Trended higher with SmartDelay
- P = 0.06
Original publication
Effects of Atrioventricular Optimization on Left Ventricular Reverse Remodeling With Cardiac Resynchronization Therapy: Results of the SMART-CRT Trial. Circ Arrhythm Electrophysiol. Published 15 May 2023. doi:10.
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