Heart failure & cardiomyopathies
His-Purkinje Conduction System Pacing Optimized Trial of Cardiac Resynchronization Therapy vs Biventricular Pacing: HOT-CRT Clinical Trial
Authors' conclusion
HPCSP-guided CRT resulted in greater change in LVEF compared with BVP.
Study context
- Population
- Patients with HF, left ventricular ejection fraction (LVEF) <50% and indications for cardiac resynchronization therapy (CRT)
- Participants
- 100 patients
- Comparison
- HOT-CRT vs biventricular pacing (BVP)
- HOT-CRTn = 50
- BVPn = 50reference
- Primary endpoint
- Change in LVEF
- Follow-up
- 6 months
Methodological detailsprospective
- Prospective
Primary result
As reported in the abstract
HOT-CRT
12.4%
SD 7.3%
BVP
8.0%
SD 10.1%
P = 0.02
Further findings
Successful CRT
P = 0.03
QRS duration · significantly decreased in both
Baseline HOT-CRT 164 ± 26 ms · BVP 166 ± 28 ms
- Successful CRT: 48 of 50 vs 41 of 50
Fluoroscopy time
- Similar between groups: 18.8 ± 12.4 min vs 23.8 ± 12.4 min
- P = 0.05
Procedure duration
- Similar between groups: 119 ± 42 min vs 114 ± 36 min
- P = 0.5
Echocardiographic response (LVEF improvement >5%)
- Occurred in 80% vs 61%
- P = 0.06
Safety
Complications
P = 0.03
Primary safety endpoint: freedom from major complications
- Similar between groups: 98% vs 94%
- P = 0.62
Original publication
His-Purkinje Conduction System Pacing Optimized Trial of Cardiac Resynchronization Therapy vs Biventricular Pacing: HOT-CRT Clinical Trial. JACC Clin Electrophysiol. Published 13 September 2023. doi:10.
Summarised from the published abstract; every number is checked against it