Heart failure & cardiomyopathies
Optimizing Cardiac Resynchronization Therapy (CRT) Lead Placement Accuracy With CMR-Guided On-Screen Targeting: A Randomized Controlled Trial (ADVISE-CRT III)
Authors' conclusion
Image-guided implantation resulted in significantly more LVPE placed in the target area and greater LVESV reduction in patients with myocardial scar.
Study context
- Population
- Heart failure patients undergoing CRT (80% with Class I CRT indication)enrolled across 7 hospitals in the Netherlands
- Participants
- 131 patients
- Comparison
- Image-guided implantation, with on-screen guidance during the procedure or conventional implantation
- Primary endpoint
- Left ventricular pacing electrode (LVPE) implantation in the target area
Methodological details7 hospitals in the Netherlands
- 7 hospitals in the Netherlands
Primary result
As reported in the abstract
P < 0.001
Secondary outcomes
LVPE placed in scarred areas (secondary endpoint) · fewer in the image-guided group
P = 0.006
LVESV reduction in patients with myocardial scar (subgroup) · greater LVESV reduction with image guidance
P = 0.028
Mean
| Outcome | Image-guided group | Conventional implantation | P value |
|---|---|---|---|
| Mean LVESV reduction · 6 months after CRT | 43.2% | 37.6% | P = 0.166 |
- Mean left ventricular end-systolic volume (LVESV) reduction: greater in the image-guided group, although not significantly
Original publication
Optimizing CRT Lead Placement Accuracy With CMR-Guided On-Screen Targeting: A Randomized Controlled Trial (ADVISE-CRT III). JACC Clin Electrophysiol. Published 19 March 2025. doi:10.
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